12/13/2023 0 Comments Upic cms award![]() ![]() The strategies include data analysis, pursuing proactive leads from other Medicare contractors or other sources such as the Fraud Investigation Database (FID), law enforcement, news media or the Internet. ZPICs employ "innovative" strategies to engage in the early detection of fraud. ![]() ZPICs perform similar audit activities as other Medicare contractors, but with a reactive and proactive focus on the identification of possible Medicare fraud. Zone 5: AdvanceMed CorporationZone 7: SafeGuard Services, LLC Zone 3: Cahaba Safeguard Administrators, LLC The contractors for the active ZPIC zones are: Providers nationwide should be aware of current ZPIC activity and prepare for its continued expansion. CMS has the discretion to award future task orders that relate to fraud, waste and abuse detection and prevention. Task Order 2 is for Medicare/Medicaid Data Matching Projects. Task Order 1 is for Medicare Parts A, B, DME, Home Health and Hospice. When CMS awards an umbrella contract to a ZPIC, two task orders are simultaneously awarded. In the Zones where they are already operating, ZPICs are very active. Zone 6: PA, NY, MD, DC, DE, ME, MA, NJ, CT, RI, NH and VT Zone 5: AL, AR, GA, LA, MS, NC, SC, TN, VA and WV Zone 2: AK, WA, OR, MT, ID, WY, UT, AZ, ND, SD, NE, KS, IA and MO Zone 1: CA, NV, American Samoa, Guam, HI and the Mariana Islands Zone Program Integrity Contractors are divided into seven geographic zones: ![]() Each ZPIC will be responsible for all benefit integrity claims in its geographic zone. As PSC umbrella contracts expire, the Centers of Medicare and Medicaid Services (CMS) will assign all PSC functions to seven ZPICs. Eventually ZPICs will be the only contractors responsible for the Medicare Benefit Integrity Program. While ZPICs and PSCs perform activities very similar to other Medicare contractors, their focus on the detection and prevention of Medicare fraud broadens the potential implications that could arise from a ZPIC audit. Zone Program Integrity Contractors (ZPICs) and Program Safeguard Contractors (PSCs) are contractors responsible for the implementation of the Medicare Benefit Integrity Program. Zone Program Integrity Contractors (ZPICs) ![]()
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