decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Medicare Contractor Role in Fraud Enforcement / Contractor Benefit Integrity Units / Medicare Fraud Information Specialist / Medicare Fraud Information Specialists
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Article Overview
This article covers the responsibilities of Medicare Fraud Information Specialists (MFIS) in coordinating fraud and abuse information across Medicare contractors, CMS, law enforcement, state agencies, and other organizations. It is relevant to compliance, program integrity, and contractor operations staff who need a high-level understanding of how fraud-related information, outreach, meetings, alerts, and training are managed.
Why This Topic Matters
Understanding the MFIS role helps organizations identify where fraud-related information is routed, who coordinates communication, and how contractor program integrity support is organized within Medicare.
What You Will Learn
- How MFIS functions support Medicare fraud and abuse information sharing
- Which organizations and stakeholders MFIS coordinates with
- The general types of fraud-related communication, outreach, and training activities involved
- How contractor benefit integrity support is organized at a high level
Who Should Read This
- Medicare contractors
- Compliance staff
- Program integrity staff
- Billing and coding managers
- Provider relations staff
- Beneficiary services staff
- Health care fraud prevention personnel
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