Iowa Medicaid Selects Ingenix for Payment Accuracy Initiative

Iowa and the Des Moines-based Iowa Medicaid Enterprise (IME), a combination of state employees and commercial vendors responsible for managing Iowa’s $3 billion Medicaid program, has chosen Eden Prarie, Minn.-based Ingenix to manage its Program Integrity initiative to help ensure that taxpayer dollars are properly spent.

IME has awarded Ingenix a three-year contract to implement a program integrity effort that Ingenix and Iowa expect to yield more than $20 million annually in recoveries and cost avoidance through identification of fraud, abuse, errors and other inappropriate payments. The contract may be extended if the State is satisfied with Ingenix’s performance.

Iowa’s Medicaid program covers nearly 450,000 beneficiaries and 38,000 care providers, and is ranked among the nation’s most accurate systems by the Centers for Medicare & Medicaid Services (CMS). In a recent Payment Error Rate Measurement (PERM) audit–which measures overpayments to Medicaid care providers and errors in calculating beneficiary eligibility–Iowa’s error rate was approximately half the national average. IME expects its agreement with Ingenix will further strengthen Iowa’s Medicaid program integrity efforts.