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Medicare Drug Integrity Contractor's Activities

As required by the Comprehensive Addiction and Recovery Act of 2016, this study will fulfill OIG's mandate to review the effectiveness of the Medicare Drug Integrity Contractor (MEDIC) in identifying, combating, and preventing fraud under the Medicare program, including how the MEDIC assists in determining beneficiaries at risk for drug abuse. Since 2013, there have been policy, regulatory, and statutory changes that affect the way the MEDIC accesses data needed to perform its required benefit integrity activities. This study will focus on the results of the MEDIC's benefit integrity activities in Medicare Part C and Part D. It also will describe how the MEDIC assists plan sponsors in identifying potential at-risk beneficiaries. Finally, it will identify any barriers and challenges the MEDIC has experienced while performing its benefit integrity activities.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Completed Centers for Medicare & Medicaid Services Medicare Drug Integrity Contractor's Activities Office of Evaluation and Inspections OEI-03-17-00310 2018

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