National Benefit Integrity MEDIC (NBI MEDIC)

After the award of the NBI MEDIC contract to QIS for regional Part C and D investigation services, CMS assigned responsibility to Qlarant to serve as the NBI MEDIC in all fifty states and Puerto Rico. The objective of the NBI MEDIC program was to monitor the prescription drug program and investigate beneficiary complaints and leads for potential fraud, waste, and abuse related to Medicare prescription drug benefits. In September 2013, CMS changed the focus of the services to a greater emphasis on data analytics and trend analysis of fraudulent practices, which involved the use of a Qlarant proprietary, advanced data analytics tool. The NBI MEDIC contract transitioned into the Investigations MEDIC (I-MEDIC) contract, a national contract that Qlarant has held since.