Medicare ZPIC audits appearing in Midwest states

March 18, 2012 — Doctors of chiropractic in several Midwest states recently received audit letters from a Medicare Zone Program Integrity Contractor (ZPIC).

ZPIC audits are different from previous CERT, claims contractor (e.g., probe reviews), or other Medicare audits. ZPIC audits are even more serious, as the primary goal of the ZPIC is to investigate instances of suspected Medicare fraud, waste and abuse, and could involve potential referral to law enforcement for civil or criminal investigation for fraud.

In response, the American Chiropractic Association’s (ACA) Medicare Audit Defense Task Force has been working with both state associations and affected DCs to provide them with webinars related to understanding ZPIC audits and preliminary information gained from direct discussions with the ZPIC program managers.

For further information on ZPIC audits and/or the ACA’s Medicare Audit Defense Taskforce, please contact Meghann Dugan-Haas at mdugan-haas@acatoday.org or go to the ACA website at acatoday.org/auditdefense.

Source: DeWitt Ross & Stevens S.C., dewittross.com