CMS Woes: Zone Program Integrity Contractors (ZPICs) Criticized for Oversight in Fraud Investigations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Zone Program Integrity Contractors (ZPIC) are private companies or business entities, that have contracted with the Centers for Medicare and Medicaid Services (CMS). Their purpose is to carry out certain functions related to auditing for possible fraud, that Medicare regional carriers (now called Medicare Administrative Contractors or “MACs”) performed in the past. They are specifically charged by CMS to data mine, identify, and investigate potentially fraudulent behavior in Medicare providers.
Because of this, health care providers that receive a letter from the ZPIC often see it as a potential death sentence, and certainly an eye-opening event, because it involves investigating for fraudulent activity. However, in recent years CMS has been criticized about its oversight (actually, lack of oversight) of these fraud-detection contractors.
Taking a […]
By George F. Indest III, J.D., M.P.A., LL.M. Board Certified by The Florida Bar in Health Law
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law