Notably, ZPICs have traditionally asserted that, unlike their Recovery Audit Contractor (RAC) counterparts, they are not “bounty hunters.” They base this argument on the fact that unlike RACs, ZPICs are not paid on a contingency basis. Zone 7 – SafeGuard Services : Florida, Puerto Rico and.Zone 6 – SafeGuard Services : Pennsylvania, New York, Maryland, District of Columbia, Delaware, Maine, Massachusetts, New Jersey, Connecticut, Rhode Island, New Hampshire and Vermont.Zone 5 – AdvanceMed (an NCI Company) : Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia.Zone 4 – Health Integrity: CO, NM, OK, TX.Zone 3 – AdvanceMed (an NCI Company ) : Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin.Zone 2 – AdvanceMed (an NCI Company) : Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming.Zone 1 – SafeGuard Services : California, Hawaii, Nevada and the territories of American Samoa, Guam, the Northern Mariana Islands, Palau, the Marshall Islands and the Federal States of Micronesia.Listing of ZPICs Previously Operating Under a Contract with CMS To date, CMS has awarded all of the ZPIC contracts and is close to completing the transition over from the PSC system. When the contracts expired, CMS transferred the PSCs’ fraud detection and deterrence functions over to ZPICs around the country. Īt the time of transition, there were twelve PSCs that had been awarded umbrella contracts by CMS. Since the enactment of MMA, ZPICs have largely taken over the program integrity duties previously handled by Program Safeguard Contractors (PSCs). The Centers for Medicare and Medicaid Services (CMS) was required to use competitive measures to replace the current Medicare Fiscal Intermediaries (Part A) and Carriers (Part B) contractors with Medicare Administrative Contractors (MACs) Īfter setting up the new MAC regions, CMS was required to create new entities, called Zone Program Integrity Contractors (ZPICs) andĬMS worked to consolidate its existing program integrity efforts. On December 8, 2003, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) was signed into law.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |