The Investigations Medicare Integrity Contractor (I-MEDIC) is a task order under the Unified Program Integrity Contractor IDIQ contract vehicle. The overall strategy of this 10-year contract is to detect, prevent, and proactively deter fraud, waste, and abuse (FWA) in Medicare Parts C and D.
The scope of work encompasses complaint intake and response; data analysis; assessing leads from various sources; investigative actions; administrative actions; referrals; and program integrity efforts related to potential fraud, waste and abuse from prescribers, pharmacies and beneficiaries. The I-MEDIC team, comprised of experienced medical reviewers, data analysts, investigators and subject matter experts, coordinates with staff from the Centers for Medicare & Medicaid Services (CMS) (the contract Sponsor), CMS contractors and other stakeholders to accomplish its goals. Federal law enforcement agencies may submit a Request for Information (RFI) to obtain Medicare Prescription Drug Event (PDE) data. Use the following HIPAA compliant form in lieu of Program Integrity Manual (PIM) exhibit 25 (DOJ) or Exhibit 37 (OG).
Data Analysis Request For Information (RFI) Form (pdf)
Request For Assistance (RFA) Form (pdf)
