Health Integrity, LLC
Keeping the Trust
MissionHealth Integrity’s mission is to protect the fiscal and clinical integrity of healthcare systems in the communities we serve.
Created in 2006 to satisfy CMS that there would be no conflicting interests with Delmarva Foundation and the Medicare D contract, Health Integrity monitors the Medicare Prescription Drug program and investigates reports of potential fraud, waste, or abuse from Medicare beneficiaries.
Along with referring confirmed cases to the Office of Inspector General (OIG) for prosecution, Health Integrity also provides data, medical and pharmaceutical experience, audits, and training expertise. As the first Medicare Drug Integrity Contractor (MEDIC) for CMS, Health Integrity is one of only eight organizations in the country selected to monitor the Prescription Drug plan.
As CMS first implemented the program in 2005, Health Integrity provided coverage for the entire United States, and after December 2006, become the Southeast MEDIC covering seven states—Virginia, North Carolina, South Carolina, Tennessee, Alabama, Georgia, Florida—and Puerto Rico.