The NAMPI Board is excited to share progress on a key initiative!
Over the past year, we gathered Program Integrity data and statistics from states and territories, and we are proud to introduce Program Integrity 360 (PI-360)—a comprehensive, full-circle view of Medicaid program integrity.

All PI-360 data and State/Territory Exclusions data collected last year are now available in the Resources Library on the NAMPI Portal:

• PI-360 [Program Integrity 360 – 2025 Data]
• State/Territory Exclusions Data [State/Territory Program Integrity Exclusions Data – 2025]

Building on last year’s PI-360 data, our next goal is to update and expand this information, striving for 100% participation from all states and territories.

Data Points Collected in 2025

• Organizational Structure
• Staff Structure
• Systems / Databases Used
• Services Contracted
• Managed Care Entity Information
• Approved CMS Waivers
• Number of Enrolled Medicaid Members
• State Fiscal Year (SFY) Start and End Dates
• Overpayments Recovered for SFY 2023
• Cost Savings/Avoidance Dollars for SFY 2023

Potential New Data Points for 2026

• Extrapolation
  (Who performs it: in-house, contractor, or both? Explain)
• Staff Credentials (e.g., CPIP, RN)
  (List of staff positions with required certifications)
• Cost Avoidance / Return on Investment / Program Savings
  (Define how these are calculated)
• Covered Lives per Investigator / Reviewer / Auditor
  (Enrolled members per PI staff member)
• Covered Providers per Program Integrity FTE
  (Ratio of staff to enrolled providers)
• Providers Terminated for Cause and/or Excluded
  (Are these lists publicly available?)
• Felony Charges for Medicaid Fraud
  (State statute or regulation allowing felony convictions)