Medicare Managed Care
Program Integrity Contractor

Indefinite Delivery / Indefinite Quantity

IntegriGuard is one of eight companies nationwide that has been designated a Medicare Managed Care Program Integrity Contractor (MMC-PIC) by the Centers for Medicare & Medicaid Services (CMS).

MMC-PICs are special contractors for CMS' Medicare Integrity Program (MIP). The MIP was established under Section 1893 of the Social Security Act to strengthen the ability of CMS to deter fraud and abuse in the Medicare Program. Dedicated to program integrity activities for the Medicare Managed Care (MMC) program, MMC-PIC's major goals are as follows:

• Identify areas of vulnerability for waste, fraud, and abuse in the MMC program
• Identify waste, fraud, and abuse currently occurring in the MMC program
• Develop current incidents of waste, fraud, and abuse for referral to CMS
• Deter and prevent future waste, fraud, and abuse by providing recommendations to CMS on how to strengthen areas of vulnerability found in the MMC program
• Assess areas of vulnerability in CMS' monitoring and administration of the MMC program

Since our MMC-PIC designation was awarded in July 2001, IntegriGuard has been able to competitively bid on CMS task orders that address program integrity issues within the MMC program. Under the MMC-PIC umbrella contract, IntegriGuard currently holds the Managed Care Payment Validation Task Order.