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Medicare-Medicaid Data Match Program

2. Medicare Medicaid Data Match Program. Medi-Medi is a partnership between Medicaid and Medicare that enhances collaboration and reduces fraud, waste, and abuseMedi-Medi is accomplished by matching Medicaid and Medicare data to identify improper billing and utilization patterns. Medi-Medi include

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Medicare-Medicaid Data Match Program

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    1. 1 Medicare-Medicaid Data Match Program Lourdes Grindal Miller Medi-Medi Program Lead Program Integrity Group Centers for Medicare & Medicaid Services

    2. 2 Medicare Medicaid Data Match Program Medi-Medi is a partnership between Medicaid and Medicare that enhances collaboration and reduces fraud, waste, and abuse Medi-Medi is accomplished by matching Medicaid and Medicare data to identify improper billing and utilization patterns. Medi-Medi includes state, regional, and national efforts and requires collaboration among state Medicaid agencies, CMS, and state and federal law enforcement officials.

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    4. 4 How Medi-Medi Works CMS funds and oversee the PSC/ZPIC Data warehousing, matching and analysis Medi-Medi Steering Committee Identification and prioritization of potential vulnerabilities Pursuing fraud, waste, and abuse leads generated by the program

    5. 5 Examples of Projects Time Dependent Studies Multiple Places of Service DME Services Received While under a Medicare or Medicaid Hospice Stay Aberrant Patterns of Utilization: Nerve Block Injections Excessive Glucose Strips

    6. 6 Deficit Reduction Act of 2005 (DRA) Creation of the Medicaid Integrity Program Establishment of a stable and ongoing funding source for the Medi-Medi Program Expansion: $12 Million in FY 2006 $24 Million in FY 2007 $36 Million in FY 2008 $48 Million in FY 2009 $60 Million in FY 2010 and each fiscal year thereafter

    7. 7 Implementing DRA Medi-Medi expansion will begin in 2008. CMS will award Zone Program Integrity Contractors (ZPICs), which will consolidate Medicare Parts A, B, C, D, and Medi-Medi Benefit Integrity Activities. CMS is considering a regional approach to Medi-Medi.

    8. 8 ZPIC Jurisdictions

    9. 9 Additional Benefits Medi-Medi National Coordinator Improved information sharing through a secure website Catalog of data analysis projects Document sharing Implementation support Cross Training Medicare and Medicaid Data analysis tools One PI Co-location opportunities Enhanced project and case tracking in the Fraud Investigation Database (FID)

    10. 10 Joining Medi-Medi If your state is interested in becoming a Medi-Medi state or if you would like more information, please contact Lourdes Grindal Miller or email the Medi-Medi at medi-medi@cms.hhs.gov

    11. 11 Contact Information Lourdes Grindal Miller Centers for Medicare & Medicaid Services 7500 Security Boulevard Mail Stop: C3-02-16 Baltimore, MD. 21244-1850 Telephone: (410) 786-1022 lourdes.grindalmiller@cms.hhs.gov

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