CMS works with OIG, DOJ and the FBI to ensure Medicare program integrity. CMS works with OIG and the States to ensure Medicaid program integrity. Under the Affordable Care Act (ACA), State Medicaid agencies are required to contract with Medicaid Recovery Auditors (Medicaid RACs) to identify and recover overpayments and to identify underpayments. States must also develop processes for entities to appeal RA determinations, and coordinate RA efforts with other Federal and state law enforcement agencies. Generally, under Federal law, States are required to have a Medicaid Fraud Control Unit (MFCU).
In 2009, HHS, OIG, DOJ joined forces to create the Health Care Fraud Prevention and Enforcement (HEAT) to fight both Medicare and Medicaid Fraud.