Center for Program Integrity

E500275

government agency division program integrity organization

The Center for Program Integrity is a division within the Centers for Medicare & Medicaid Services responsible for preventing fraud, waste, and abuse in federal health care programs and ensuring proper payment and program compliance.

Try in SPARQL Jump to: Surface forms Disambiguation Statements Elicitation Referenced by

All labels observed (3)

Label	Occurrences
Affordable Care Act program integrity provisions	1
Center for Financing, Access and Cost Trends	1
Center for Program Integrity canonical	1

How this entity was disambiguated

This entity first appeared as the object of triple T5166833 — resolving that mention is where its identity was fixed. The disambiguator weighed these candidate entities and picked the highlighted one (or “None”, minting a new entity). This is how homonymy is resolved: the same surface form can point to different entities.

NED1 Entity disambiguation (via context triple) gpt-5-mini-2025-08-07

Target entity: Center for Program Integrity
Context triple: [Centers for Medicare & Medicaid Services, hasPart, Center for Program Integrity]

A. Office of Program Integrity
The Office of Program Integrity is a unit within the Oregon Department of Human Services responsible for preventing, detecting, and addressing fraud, waste, and abuse in the agency’s programs.
B. Center for Medicare and Medicaid Innovation
The Center for Medicare and Medicaid Innovation is a federal agency within CMS that tests and implements new payment and service delivery models to improve quality and reduce costs in Medicare, Medicaid, and CHIP.
C. Centers for Medicare & Medicaid Services
The Centers for Medicare & Medicaid Services is a U.S. federal agency within the Department of Health and Human Services that administers the nation’s major public health insurance programs, including Medicare and Medicaid, and sets key standards for healthcare quality and reimbursement.
D. Center for Clinical Standards and Quality
The Center for Clinical Standards and Quality is a division of the U.S. federal health system responsible for developing, implementing, and enforcing national healthcare quality and safety standards across Medicare- and Medicaid-participating providers.
E. Office of Health Insurance Programs
The Office of Health Insurance Programs is a division of New York State government responsible for administering public health insurance initiatives such as Medicaid and related coverage programs.
F. None of above. chosen
G. Unsure - the case is ambiguous/there is not enough information to decide.

NED2 Entity disambiguation (via description) gpt-5-mini-2025-08-07

Target entity: Center for Program Integrity
Target entity description: The Center for Program Integrity is a division within the Centers for Medicare & Medicaid Services responsible for preventing fraud, waste, and abuse in federal health care programs and ensuring proper payment and program compliance.

A. Office of Program Integrity
The Office of Program Integrity is a unit within the Oregon Department of Human Services responsible for preventing, detecting, and addressing fraud, waste, and abuse in the agency’s programs.
B. Center for Medicare and Medicaid Innovation
The Center for Medicare and Medicaid Innovation is a federal agency within CMS that tests and implements new payment and service delivery models to improve quality and reduce costs in Medicare, Medicaid, and CHIP.
C. Centers for Medicare & Medicaid Services
The Centers for Medicare & Medicaid Services is a U.S. federal agency within the Department of Health and Human Services that administers the nation’s major public health insurance programs, including Medicare and Medicaid, and sets key standards for healthcare quality and reimbursement.
D. Center for Clinical Standards and Quality
The Center for Clinical Standards and Quality is a division of the U.S. federal health system responsible for developing, implementing, and enforcing national healthcare quality and safety standards across Medicare- and Medicaid-participating providers.
E. Office of Health Insurance Programs
The Office of Health Insurance Programs is a division of New York State government responsible for administering public health insurance initiatives such as Medicaid and related coverage programs.
F. None of above. chosen

Statements (48)

Predicate	Object
instanceOf	government agency division ⓘ program integrity organization ⓘ
affiliation	U.S. Department of Health and Human Services ⓘ linked to: United States Department of Health and Human Services
collaboratesWith	Medicare Administrative Contractors ⓘ U.S. Department of Health and Human Services Office of Inspector General ⓘ linked to: Office of the Inspector General U.S. Department of Justice ⓘ linked to: United States Department of Justice state Medicaid agencies ⓘ
country	United States ⓘ linked to: United States of America
employer	federal civil service employees ⓘ
focusArea	improper billing and payment errors ⓘ provider enrollment screening and oversight ⓘ
goal	protect taxpayer resources ⓘ protect the Medicare Trust Funds ⓘ reduce improper payments in Medicare and Medicaid ⓘ strengthen program integrity safeguards ⓘ
jurisdiction	federal health care programs in the United States ⓘ
legalAuthority	Affordable Care Act program integrity provisions ⓘ linked to: Center for Program Integrity Social Security Act program integrity provisions ⓘ
locatedInOrganization	Centers for Medicare & Medicaid Services headquarters structure ⓘ
operatesInSector	health care ⓘ public health insurance ⓘ
oversees	Medicaid program integrity initiatives at the federal level ⓘ Medicare program integrity contractors ⓘ
parentOrganization	Centers for Medicare & Medicaid Services ⓘ
partOf	Centers for Medicare & Medicaid Services ⓘ
primaryFunction	ensuring program compliance in federal health care programs ⓘ ensuring proper payment in federal health care programs ⓘ preventing abuse in federal health care programs ⓘ preventing fraud in federal health care programs ⓘ preventing waste in federal health care programs ⓘ
programArea	Affordable Care Act health insurance programs ⓘ linked to: Affordable Care Act Children's Health Insurance Program ⓘ Medicaid ⓘ Medicare ⓘ
regulates	Medicaid providers with respect to program integrity requirements ⓘ Medicare providers and suppliers with respect to program integrity requirements ⓘ
responsibility	beneficiary protection from fraud and abuse ⓘ collaboration with law enforcement on fraud cases ⓘ coordinating program integrity activities across CMS ⓘ data analysis to identify aberrant billing patterns ⓘ detecting health care fraud schemes ⓘ developing policies to reduce improper payments ⓘ overseeing contractors that perform program integrity work ⓘ provider and supplier oversight ⓘ
subordinateTo	Centers for Medicare & Medicaid Services Administrator ⓘ linked to: Centers for Medicare & Medicaid Services
usesMethod	claims data analytics ⓘ risk-based program integrity strategies ⓘ
website	https://www.cms.gov/about-cms/center-program-integrity ⓘ

How these facts were elicited

Referenced by (3)

Full triples — surface form annotated when it differs from this entity's canonical label.

Centers for Medicare & Medicaid Services → hasPart → Center for Program Integrity ⓘ

subject linked to: CMS

Center for Program Integrity → legalAuthority → Affordable Care Act program integrity provisions ⓘ

linked to: Center for Program Integrity

Medical Provider Component → operatedBy → Center for Financing, Access and Cost Trends ⓘ