Plan Program Integrity Medicare Drug Integrity Contractor (PPI MEDIC)

The PPI MEDIC serves as a national contractor responsible for providing oversight of the Medicare Parts C and D programs to ensure the protection of the Medicare Trust Fund. CMS seeks to contract with an external entity to support CMS audits and program integrity oversight activities related to fraud, waste, and abuse efforts within the Medicare Parts C and D programs. Its tasks include data analysis, audits and reviews of Medicare Advantage Organizations (MAOs),  including Medicare Advantage Prescription Drug (MA-PD) plan sponsors and Prescription Drug Plan (PDP) sponsors, as well as outreach, education, and referrals to law enforcement.