ZPIC Audits
Wil
Description
Collection
Title:
ZPIC Audits
Creator:
Wil
Date:
6/28/2013
Text:
Hello Colleagues and Guests,
This may be old news, but someone thought it should be passed along.
Following is an excerpt regarding the ZPIC folks.
So, who are ZPIC auditors anyway? Zone Program Integrity Contractors
are organizations hired indirectly (or in connection with other CMS
affiliated contractors) by CMS to perform a wide range of medical
review, data analysis and Medicare audits.While ZPIC audits are similar
in many ways to other Medicare audits currently being performed
nationwide they do differ in one very important aspect -- potential
Medicare fraud < <URL Redacted>>implications. Of all
the current CMS audit initiatives -- RAC audits, MIC audits, etc. -- it
is vital that providers facing ZPIC audits immediately and effectively
address targeted audit issues.
I know of one company that received several small dollar amount non-ZPIC
audit requests and ignored them, due to the administrative time and
costs involved with responding. At a glance, you would think this would
make sense and be okay, but such is evidently not the case. CMS looked
at this as though they had something to hide since they did not respond
and the company was turned over to the ZPIC which caused them a great
deal of grief. So, unless things have changed, it is important to
respond to each audit request, regardless of the financial burden
involved. Hope this is useful.
Wil Haines, CPO
MaxCare Bionics
Avon, IN 46123
_
_
This may be old news, but someone thought it should be passed along.
Following is an excerpt regarding the ZPIC folks.
So, who are ZPIC auditors anyway? Zone Program Integrity Contractors
are organizations hired indirectly (or in connection with other CMS
affiliated contractors) by CMS to perform a wide range of medical
review, data analysis and Medicare audits.While ZPIC audits are similar
in many ways to other Medicare audits currently being performed
nationwide they do differ in one very important aspect -- potential
Medicare fraud < <URL Redacted>>implications. Of all
the current CMS audit initiatives -- RAC audits, MIC audits, etc. -- it
is vital that providers facing ZPIC audits immediately and effectively
address targeted audit issues.
I know of one company that received several small dollar amount non-ZPIC
audit requests and ignored them, due to the administrative time and
costs involved with responding. At a glance, you would think this would
make sense and be okay, but such is evidently not the case. CMS looked
at this as though they had something to hide since they did not respond
and the company was turned over to the ZPIC which caused them a great
deal of grief. So, unless things have changed, it is important to
respond to each audit request, regardless of the financial burden
involved. Hope this is useful.
Wil Haines, CPO
MaxCare Bionics
Avon, IN 46123
_
_
Citation
Wil, “ZPIC Audits,” Digital Resource Foundation for Orthotics and Prosthetics, accessed April 19, 2025, https://library.drfop.org/items/show/235308.
