Our Mission

Provide systems of sustainable and equitable oversight that targets accountability and compliance, focusing on prevention of fraud, waste, and abuse of Medicaid programs.

Our Purpose

Ensure state and federal taxpayer dollars are spent appropriately on delivering quality services, necessary care, and preventing fraud, waste, and abuse within the Medicaid Programs.

Program Integrity Department

  • Department of Health and Human Services (HHS)
  • Iowa Medicaid
  • State Program Integrity and Compliance Admin
  • Program Integrity Unity
    • Audits and Investigations
    • PI Fiscal Management
    • Managed Care Entities PI Reporting and Oversight Group
    • PI Data Analytics

Program Integrity Responsibilities

  • Federal and state rules regulation governance and enforcement
  • Provider enrollment and screening oversight
  • Exclusions and Sanctions
  • Program Integrity Oversight
    • Medical Benefit Managers
    • Managed Care Organizations (MCOs)
  • Dental Benefit Managers (DBMs)
  • Fraud, Waste, and Abuse Audits and Investigations
  • Payment Error Rate Measurement (PERM) Audits
  • Post-Pay Overpayment Recoveries

Iowa Medicaid Sanction List

View at Iowa Medicaid Sanctions List.

  • A list of providers that are found to be in violation of the Iowa Medicaid Program.
  • The list identifies all individuals, organizations, and entities that Iowa Medicaid Program Integrity Unit has taken an adverse action against for the following reasons:
    • Involuntarily Terminated from Participation
    • Involuntarily Suspended from Participation
    • OIG Excluded
    • Medicare Revocations
    • Outstanding Overpayments
  • Sanction list verifications should be sent to iaverify@dhs.state.ia.us

Program Integrity Resource Library

Program Integrity Education and Training Resources

Payment Error Rate Measurement (PERM)

The PERM page can be found here.

Program Integrity Forms

Contact Us