What we do

Fee-for-Service Program Support

Myers & Stauffer provides Medicaid fee-for-service (FFS) consulting, reimbursement, payment integrity, program integrity, and financial management services to state Medicaid agencies. Our multidisciplinary teams help agencies strengthen Medicaid FFS programs through claims analysis, provider reimbursement, payment validation, compliance reviews, data analytics, and policy support that improve payment accuracy, reduce improper payments, ensure regulatory compliance, and promote effective program administration across diverse provider types and services.

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Supporting Payment Accuracy, Compliance, & Oversight in Fee-for-Service Medicaid Programs

Medicaid FFS programs remain a foundational component of state Medicaid systems, providing direct reimbursement to providers for covered services. While many states have expanded managed care, FFS continues to play a critical role for certain populations, provider types, and services.

Effective oversight of FFS programs requires strong controls to ensure that payments are accurate, services are appropriate, and program requirements are met. Agencies must manage complex reimbursement methodologies, large volumes of claims data, and evolving regulatory expectations.

We support state Medicaid agencies in administering and overseeing FFS programs, providing independent, unbiased analysis to bolster payment accuracy, compliance, and program performance.

Fee-for-Service Program Expertise

Our experience spans core components of Medicaid FFS programs, including:

  • Claims-based reimbursement and payment systems.
  • Provider billing and coding requirements.
  • Payment policy interpretation and implementation.
  • Financial and utilization analysis.
  • Program integrity and audit activities.

We bring a practical understanding of how FFS programs operate and the challenges agencies face in maintaining effective oversight.

Our Fee-for-Service Support

Ensuring accurate payment is a central objective of FFS program administration. Agencies must validate that claims are paid correctly and in accordance with program rules.

We support agencies in:

  • Claims review and payment validation.
  • Identification of billing errors and improper payments.
  • Evaluation of claims processing systems and controls.
  • Analysis of payment patterns and anomalies.
  • Support for corrective actions and process improvements.

FFS programs require providers to comply with detailed billing, coding, and documentation requirements. Oversight of these activities is essential to maintaining program integrity.

We assist agencies in:

  • Reviewing provider billing and coding practices.
  • Evaluating compliance with program requirements.
  • Assessing documentation supporting billed services.
  • Identifying trends and areas of non-compliance.
  • Supporting provider education and corrective action efforts.

FFS reimbursement is driven by payment policies, fee schedules, and rate methodologies that must be regularly evaluated and updated.

We support agencies in:

  • Interpreting and implementing payment policies.
  • Evaluating fee schedules and reimbursement methodologies.
  • Conducting financial and rate impact analysis.
  • Assessing alignment with Medicare and other benchmarks.
  • Supporting policy updates and program changes.
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FFS programs generate significant volumes of claims and utilization data that can be used to support oversight and decision-making.

We assist agencies in:

  • Analyzing claims and utilization data.
  • Identifying trends, outliers, and emerging risks.
  • Supporting program monitoring and reporting.
  • Developing data-driven insights to inform policy and oversight.
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Integration with Program Integrity & Managed Care

FFS programs are closely connected to broader Medicaid delivery systems, including managed care and program integrity activities. Effective oversight requires coordination across these areas.

We support agencies in:

  • Aligning FFS oversight with program integrity efforts.
  • Supporting audit and compliance activities.
  • Identifying risks across FFS and managed care environments.
  • Providing insights that inform broader program strategy.
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nationwide experience

Why Agencies Hire Myers & Stauffer

experience & approach

Our FFS work is grounded in extensive experience supporting state Medicaid agencies. We bring:

  • Deep knowledge of Medicaid payment systems and policies.
  • Integrated financial, analytical, and compliance expertise.
  • Experience across a wide range of provider types and services.
  • An independent and impartial perspective.

We tailor our approach to align with each state’s program structure, regulatory requirements, and operational priorities.

Results & Outcomes

Our FFS services support:

  • Improved payment accuracy and reduced improper payments.
  • Enhanced oversight of provider billing and reimbursement.
  • Strengthened compliance with program requirements.
  • Better use of data to support decision-making.
  • Increased transparency and accountability.
Supporting effective fee-for-service programs

We work with agencies to strengthen Medicaid fee-for-service programs through improved payment accuracy, enhanced oversight, and data-driven analysis. Our focus is on supporting efficient, compliant programs that ensure appropriate use of public funds while maintaining access to care.

The Transformative Power of Partnership

Connect With Our Team

Partner with experts who understand the complexities of health and human services programs. Let us guide your organization through the industry’s unique challenges and opportunities.

Tara Clark, CPA
Member

Email: tclark@mslc.com
Phone Number: 888-749-5799

Tammy Martin, CPA
Member

Email: tammym@mslc.com
Phone Number: 208-378-4100

In the Words of our Clients…

Myers & Stauffer is a highly knowledgeable and accessible contractor that knows our programs and system as well or better than our own staff. They are always willing to provide as much assistance/support as needed, and deliverables are received timely and at a reasonable cost.” 

Sharing Knowledge & strengthening programs

Recent Insights

We’re committed to advancing government health care through thought leadership, collaboration, and the open exchange of ideas that drive better outcomes. Explore our latest blogs, client alerts, case studies, and thought leadership to see how our expertise can support your goals.

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