Which organization oversees the enforcement and auditing of healthcare claims?

The Medicaid Integrity Contractor (MIC) plays a crucial role in overseeing the enforcement and auditing of healthcare claims, particularly for the Medicaid program. MICs are specifically tasked with identifying and preventing fraud, waste, and abuse in the Medicaid system. They conduct audits and provide oversight to ensure compliance with regulations and the integrity of claims submitted for reimbursement.

While Health and Human Services (HHS) holds a broader regulatory and administrative role over numerous health programs and policies, including Medicaid and Medicare, it does not specifically manage the auditing of claims on its own. Similarly, the Medicare Review Board is focused more on reviewing claims and appeals under the Medicare program rather than performing the broader enforcement and auditing function associated with all healthcare claims. The Private Insurance Commission, while it may regulate private health insurance to some extent, does not have the authority or function to conduct enforcement actions or auditing related to healthcare claims in the same way that MICs do for Medicaid.

Thus, the specific function of the MIC in enforcing and auditing healthcare claims establishes it as the correct answer in this context.