CN-680000-AA402.pdf
PDF 1 MB Posted
- Contract number
- AA402
- Issued by
- Florida
About this file
This document is an Information Exchange Agreement between the Centers for Medicare & Medicaid Services (CMS) and participating State Medicaid Agencies (SMA), specifically involving the Florida Agency for HealthCare Administration. The agreement, identified as CMS Information Exchange No. 2017-17, is designed to facilitate the exchange of Medicare and Medicaid data for the purpose of detecting fraud, waste, and abuse in healthcare programs.
The agreement allows for monthly data exchanges between CMS and the Florida Medicaid Program Integrity, utilizing the Decision Support System (DSS) to share claims and encounters data. The data will include managed care/encounter data, crossover and TPL claims, eligibility files, and provider information. The primary objective is to match data elements from both Medicare and Medicaid programs to identify potential fraudulent practices, with the exchange program to be conducted via sophisticated fraud detection software. The agreement is effective from June 1, 2019, and expires on July 1, 2023, with provisions for potential renewal, and includes comprehensive safeguards for data confidentiality and security.
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Text version
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