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Guidelines for Constructing a Compliance Program for ...

Guidelines for Constructing a Compliance Program for Medicaid Managed Care Organizations and PrePaid Health Plans A Product of the Medicaid Alliance for Program Safeguards May 2002 Guidelines For Constructing A Compliance Program for Medicaid Managed Care Organizations and Prepaid Health Plans In June 1997, CMS s Southern Consortium assumed leadership of the Medicaid Alliance for Program Safeguards (Alliance). This Alliance was established with the primary goal of preventing fraud and abuse by assisting States in their efforts, identifying proactive strategies, and sharing information with other Program integrity players.

Guidelines For Constructing A Compliance Program for Medicaid ... Medicaid Fraud Control Units, and 2 . managed care organizations in preventing, identifying, investigating, reporting, and ... instituted by a managed care entity to regulate its internal processes and train staff to

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