USIS’ Investigations Services Division (ISD) is the leading industry provider of background investigations. Our knowledgeable, experienced, trained and cleared staff share our national security focus. USIS Healthcare Solutions is part of ISD and a premier provider of compliance and investigation services that combat fraud, waste and abuse in the health care industry.
USIS provides manpower, processes, tools, and innovation that help federal Medicare and state Medicaid agencies prevent, deter and eliminate fraud, waste and improper activities in the health care industry. Our streamlined approaches allow good-faith providers to operate and protect taxpayer dollars. Most importantly, we support the transition from a pay-and-chase anti-fraud model to a fraud prevention model.
USIS is the largest commercial supplier of background investigations for the U.S. government. We conduct more than 2 million investigations annually, which is equivalent to 5 million site visits. Nationwide operations ensure cost-effective results for Medicare and Medicaid programs anywhere in the U.S.
Fight health care program fraud and promote compliance with...
Our solution combines site visits, criminal background checks and fingerprinting processes that collectively address all requirements of Final Rule 6028-FC issued by the Centers for Medicare & Medicaid Services (CMS). USIS provides reliable, efficient and value-added results that save time and alleviate the financial investment needed to establish standard operating procedures and ensure compliance.
More than 2,600 experienced field staff strategically located throughout all 50 states and U.S. territories to ensure scalability.
15-year history of developing and implementing processes that deliver high-quality reports and exceed customer quality expectations.
Technology and tools custom-designed to support a mobile workforce. GPS capability promotes rapid response, while secure, proprietary applications enable our field staff to collect records and interview information, capture photographs and submit information in real-time.
One of approximately 12 approved fingerprint channelers to the FBI. We are prepared to mobilize staff to site visit locations, conduct necessary interviews and collect fingerprints as required by the Final Rule.
Proven Track Record
- 15+ years of service to the government as a privately operated, independent entity
- Strong ability to staff resources for specific projects and new contracts
- More than 2,600 credentialed and extensively trained investigators
- Nationwide footprint and geographic scale; field organization covers 50 states,and U.S. territories
- Four business units, 22 district field offices
- Proprietary request management system automatically assigns site visits in the field
- Handheld devices capture and report site visit information
- Efficient and quality-driven case management
USIS State Medicaid Capabilities
State Medicaid Challenges
The release of Final Rule 6028-FC by the Centers for Medicare & Medicaid Services (CMS) substantially alters the enrollment standards that apply to Medicaid providers/suppliers and
puts them under greater scrutiny. Its intent is to combat fraud by enhancing screening for providers/suppliers enrolling and re-enrolling in state Medicaid programs.
The Final Rule directs state Medicaid agencies to use screening measures initially created for the Medicare program. Any prior screening measures will continue, with measures added for certain types of enrollees. The agencies must screen all initial provider/supplier applicants, including requests for new practice locations, as well as applications for re-enrollment or revalidation. Going forward, all providers will also be assigned a risk category.