MedicaidAdministrativeHigh impact
Centers for Medicare and Medicaid Services to Begin Auditing Medicaid Providers
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
We identified it
Jun 20, 2026
Summary
CMS is beginning comprehensive audits of Medicaid providers through contracted Audit Medicaid Integrity Contractors (Audit MICs) to identify overpayments and ensure proper billing and documentation. Wisconsin providers may receive audit notification letters requiring document production within two weeks and must cooperate with field or desk audits.
Action Required
Immediately: Billing team and providers must prepare for potential Medicaid audit by ensuring all Medicaid claims documentation is complete, accurate, and readily accessible. Establish audit response procedures including designated point person for audit communications, document organization system, and staff training on audit cooperation requirements. If audit notification letter is received, gather requested documents within specified timeframes (minimum 2 weeks) and coordinate entrance conference with Audit MIC.