Sunday, August 8, 2010

Another CMS Eponym

What is a “ ZPIC”  ?  (see below)



WASHINGTON (AP) - They don't seem that interested in hot pursuit. It took private sleuths hired by Medicare an average of six months last year to refer fraud cases to law enforcement.

Have you looked in your post office lately? Perhaps your photo will be up there, soon.


According to congressional investigators, the exact average was 178 days. By that time, many cases go cold, making it difficult to catch perpetrators, much less recover money for taxpayers.

A recent inspector general report also raised questions about the contractors, who play an important role in Medicare's overall effort to combat fraud.

click on the image

Groucho, Harpo and Zeppo.  Question of the day, Who were the other two Marx brothers????




Out of $835 million in questionable Medicare payments identified by private contractors in 2007, the government was only able to recover some $55 million, or about 7 percent, the report found.

Medicare overpayments - they can be anything from a billing error to a flagrant scam - totaled more than $36 billion in 2009, according to the Obama administration.


As ranking Republican on the Senate panel that oversees Medicare, Grassley is trying to find out why it takes the contractors so long, and how much the government is currently paying the companies. In 2005, taxpayers paid them $102 million.

At least seven private companies Medicare calls "Program Safeguard Contractors" are working to detect fraud, part of a program that dates to the late 1990s. They oversee specific areas of jurisdiction, and some have more than one contract with Medicare.


In practice, their performance has been uneven. The contractors have widely different track records. One identified $266 million in overpayments in 2007, while another found just $2.5 million, the Health and Human Services inspector general said in May.


The private sleuths will now be called "Zone Program Integrity Contractors" - or ZPICs for short.

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