CMS One Program Integrity (One PI)
Investment ID: 009-000005234
Overview
Program Title
CMS One Program Integrity (One PI)
Description
OnePI provides one-stop-shopping for fraud-fighting data analysts by providing them with data from the Integrated Data Repository (IDR) and analytic tools that can be accessed via the OnePI Portal.
Type of Program
Major IT Investments
Multi-Agency Category
Not Applicable
Investment Detail
One PI plays a role in many complex interactions between various programs, agencies, and contractors. CMS cannot meet its mission of improved healthcare for its expenditures without continuing to fight against Fraud, Waste, and Abuse (FWA) in the Medicare and Medicaid programs. One PI is the only comprehensive source of national Medicare data for fraud research. The Unified Program Integrity contractors (UPICs) use One PI as the primary and in many cases, exclusive source of data for FWA programs. Other Medicare contractors such as the MACs and modelers also depend on One PI to assist in data analytic needs. The increasing use of One PI data by external law enforcement HHS Office of Inspector General (OIG), the Federal Bureau of Investigations (FBI), and the US Attorney's Office attest to the increasing importance of the program outside CMS. The Department of Health and Human Services and The Department of Justice Health Care Fraud and Abuse Control Program Annual Report describes each of the programs that are contributing to fraud recovery. The One PI Portal and related business intelligence tools such as BO, SAS, and STARS are specifically mentioned as directly supporting other efforts such as the activities of the OIG and the FBI.