ZPIC's

[dlemke · Accepted solution]

ZPIC program is just like the RAC's and are designed to find and prevent waste, fraud and abuse in Medicare. They will look at billing trends and patterns focusing on providers whose billing for services are higher than the majority of providers in the community. They do not work for a contingency fees like the RAC's. There hasn't been much activity on this front but it is occurring.

The real bite to this program is that all the cases of potential fraud will be referred to the OIG for consideration with the possibility of discipline. Therefore, you should be just as concerned or even more so about this program than the RAC program and prepare just like you nwould for any other potential external audit.