The Centers for Medicare & Medicaid Services (CMS) issued a letter this week to states discussing mutual obligations and accountability on the part of the federal and state governments related to Medicaid program integrity. The letter announces that CMS and the National Association of Medicaid Directors (NAMD) are launching an executive workgroup to focus on strengthening financial management and program integrity. In addition, as indicated in the letter, CMS plans to establish a regular process to work with each state to review information on state expenditures, claims information, audit results, and other items. This information would be used to evaluate performance, identify possible inefficiencies or other issues, and highlight best practices. The guidance summarized in the letter also requires states to submit upper payment limit (UPL) demonstrations on an annual basis beginning in 2013.

Link(s): CMS Letter; Guidance Materials