In the most recently presented “Annual Report on the Medicare and Medicaid Integrity Program” to Congress, the Centers for Medicare and Medicaid Services’ (CMS) comprehensive program integrity efforts resulted in estimated Medicare savings of $14.9 billion and estimated Medicaid and CHIP federal share savings of $2.3 billion.
As a prime contractor on a top-8 Medicare cost savings contract, J29 performs critical work to ensure that fraud, waste, and abuse prevention are prioritized in government programs. Presented to Congress in October of 2024, the report highlights CMS’s commitment to protecting Medicare, Medicaid, CHIP, and Marketplace programs from fraud, waste, and abuse—fulfilling statutory requirements of the Social Security Act.
CMS’s program integrity strategy emphasizes prevention, detection, and mitigation of risks, including efforts to stop bad actors and ensure proper payments while minimizing provider burden. In FY 2023, CMS’s integrity programs led to:
- $14.9 billion in Medicare savings
- $2.3 billion in Medicaid and CHIP federal share savings
- A return on investment (ROI) of $8.3 to 1
Since 2017, J29, Inc. (J29) has been honored to support CMS on various contracts focused on processing, reviewing, and analyzing medical claims, codes, data, and audits with a mission to prevent fraud, waste, and abuse. J29 is proud to support programs that contributed over $574.4 million in savings as outlined in CMS’ report to Congress.
“While CMS drives and oversees such impactful program integrity programs which J29 directly operates as both a prime and subcontractor, the J29 team of nearly 275 employees is proud to have our hard work and dedication associated with nearly $575 million in savings on programs that we touch. We are fortunate to support and learn from such talented professionals across all of CMS, including CPI, in the program integrity mission,” stated Nick Vass, J29’s President.
The CMS Center for Program Integrity (CPI) is primarily responsible for implementing both the Medicare Integrity Program and Medicaid Integrity Program. CPI has been instrumental in supporting the program integrity mission of protecting taxpayer dollars and focusing on fraud, waste, and abuse prevention. While other CMS departments engage in integrity-related activities, this report spotlights those led or significantly contributed to by CPI.
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