Advanced Search

Home Health & Hospice Week

Fraud & Abuse:

ZPICs Take Down Home Care Providers

Published on Tue Aug 10, 2010

You might be next on the fraud contractors' hit list, experts warn. You could be in for a payment ambush that would close your doors forever if your documentation isn't pristine. Zone Program Integrity Contractors, which are Medicare's new fraud contractors, appear to be ramping up audits on home care providers throughout the United States, experts say (see related story, p. 252, for one example). Hundreds of home care providers are coming under the ZPICs' microscope, warns Tim Johnson with Jackson Davis HealthCare in Denver, which does ZPIC audit consulting. Recovery Audit Contractors have mostly focused their reviews on hospitals, and ZPICs have swooped in to cover reviews of smaller providers like home health agencies, hospices, and durable medical equipment suppliers, Johnson notes. In reports and congressional testimony, the government is depicting the home care industry as riddled with fraud, notes attorney Edward Vishnevetsky with Thompson Coe Cousins & Irons in [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Home Health & Hospice Week

View All