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Home Health & Hospice Week

Industry Notes:

Expect Harsher Scrutiny From ZPICs.

Published on Tue Jul 13, 2010

• The public -- and Congress -- are taking notice of Program Safeguard Contractors' track records, and the result could be tougher investigations for you. Back in May, the OIG issued a report noting PSCs' statistics on topics including overpayment recoupment and fraud case referrals (see Eli's HCW, Vol. XIX, No. 19, p. 151). Now Sen. Charles Gras-sley (R-Ia.) is asking why the recoupment and referral figures are so low. "Medicare is already a pay-and-chase system when it comes to fraud, waste and abuse," Grassley has told the press. "Providers are paid first, then questioned if there's a problem. Add to that mix contractors who sit on cases of ongoing fraud when they should be referring them to law enforcement, and you have a recipe for disaster." Zone Program Integrity Contractors (ZPICs) have been replacing the PSCs and are doing a better job, Medicare maintains. "By using these new contractors [...]
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