As the PPI MEDIC, Qlarant supports the efforts of CMS to proactively detect and prevent fraud, waste, and abuse in Medicare Parts C and D. Qlarant conducts proactive and reactive data analysis within Medicare Parts C and D and identifies risks and vulnerabilities. It provides a coordinated and comprehensive strategy to identify risks and inappropriate payments in Medicare Parts C and D programs, with the primary goals of conducting audits of plans, providing outreach and education, and ensuring compliance with regulatory requirements. The preliminary findings are provided to Medicare Advantage and Prescription Drug Plans for further corrective action as needed to support overall fraud, waste and abuse efforts.
Qlarant also supports CMS by identification of regulatory and sub regulatory policies that are in need of refinement to address program vulnerabilities. The PPI MEDIC replaced the National Benefit Integrity MEDIC contract, held by Qlarant for 15 years. For information requests and submission of complaints, please refer to the IMEDIC contract for details and forms.
