Medicare Drug Integrity Contractor

Indefinite Delivery / Indefinite Quantity

IntegriGuard is one of eight companies nationwide designated as a Medicare Drug Integrity Contractor (MEDIC) by the Centers for Medicare & Medicaid Services (CMS). As a MEDIC, IntegriGuard is eligible to competitively bid on tasks intended to provide Benefit Integrity (BI) support in audit, oversight, and anti-fraud and abuse efforts associated with the Medicare Prescription Drug Benefit.

Title I of the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) (P.L.108-173) was signed into law on December 8, 2003. MMA established the new Medicare Part D benefit under Title XVIII of the Social Security Act.

The Part D benefit and an employer subsidy for qualified retiree health plans will begin on January 1, 2006. Coverage for the new benefit will be provided by private Prescription Drug Plans (PDP), which offer prescription drug-only plans, and Medicare Advantage Prescription Drug Plans (MA-PD), which offer healthcare and prescription drug coverage.

In order to ensure the protection of the Medicare Trust Fund and the Medicare beneficiaries, as well as to provide appropriate oversight of the PDPs and MA-PDs, CMS identified the need to contract with outside entities. These entities, known as MEDICs, will work with CMS in five separate national regions to monitor all aspects of program compliance in partnership with other stakeholders, such as the Office of Inspector General (OIG), Department of Justice (DOJ), and other Medicare contractors to ensure the success of the Medicare Prescription Drug Benefit.