One Program Integrity
On September 30, 2006, the Centers for Medicare and Medicaid Services (CMS) awarded the One Program Integrity (One PI) contract to SafeGuard Services LLC (SGS). The purpose of the One PI system is to establish an enterprise resource as a single source of information for all CMS fraud, waste, and abuse detection activities. The program will, for the first time, provide streamlined, centralized access and analysis for standardized Medicaid data across multiple states, integrated with data from Medicare Parts A, B, and D. The availability of a centralized source for accessing the tremendous volume of data on claims, providers, and beneficiaries will enable consistent, reliable, and timely analyses, improving the ability to detect fraud, waste, and abuse.
The centralization of Medicare and Medicaid data in this one system will create efficiencies for CMS internal departments, contractors supporting CMS field operations, state Medicaid agencies, and law enforcement.
The application suite includes a decision support tool used to perform sophisticated data analyses; a Commercial-Off-The-Shelf (COTS) suite of query, analysis and business intelligence tools; portal collaboration and communication tools. It will evolve at user direction to include products such as statistical analysis, sampling and reporting tools.
Patrick Gorman is the SGS One PI Program Director, supporting the client site in Baltimore, Maryland.