Centers for Medicare and Medicaid Services (CMS)

CMS Awards Zone 6 ZPIC Contract to SafeGuard Services

Medicare, Medicaid & Private Payor Updates /

(August 15, 2015): The Centers for Medicare and Medicaid Services (CMS) has awarded the contract for Zone Program Integrity Contractor (ZPIC) services for Zone 6 to SafeGuard Services, LLC. Zone 6 encompasses Maryland, Delaware, Washington, D.C., Pennsylvania, New Jersey, New York, Connecticut, Massachusetts, Rhode Island, Vermont, New Hampshire, and Maine. SafeGuard is the current program […]

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The Medicare Audit Improvement Act Appears Promising at First Glance. Is it Really the Answer?

Medicare, Medicaid & Private Payor Updates /

(November 12, 2012): The AHA Supports the Medicare Audit Improvement Act of 2012. Is this Legislation Going to Help Physicians or Not? On October 16, 2012, a new bill was introduced by Representative Sam Graves (R-MO) entitled the “Medicare Audit Improvement Act of 2012”. This legislation was immediately supported by the American Hospital Association (AHA),

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Data Mining is Being Used for ZPICs Targeting Purposes

Medicare, Medicaid & Private Payor Updates /

(November 16, 2011): Many providers believe that their practice is a normal one – average billings, average patient load, costs of care which are consistent with industry standards – and that they need not be concerned with undergoing a Medicare post payment audit for being a “statistical outlier.” As you may know, Medicare and Medicaid

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RAC Audits of Physician Practices, Home Health, Hospice, and DME Providers, are Expected to Increase.

Home Health & Hospice /

(June 25, 2010): The purpose of this series of articles is to assess the Recovery Audit Contractor (RAC) Program from the perspective of physicians, home health, hospice, durable medical equipment (DME) providers, and other relatively small Medicare providers. As many non-hospital providers will acknowledge, early cries of wolf by law firms and consultants did a

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GAO Testimony Recommends CMS Improve Enrollment, Payment, and Oversight Procedures

Medicare, Medicaid & Private Payor Updates /

(June 23, 2010): Yesterday we told you about recent GAO testimony before Congress regarding the impact of health care reform on HHS enforcement efforts. On the same day, GAO Health Care Director Kathleen M. King offered Congress testimony that made clear that the Centers for Medicare & Medicaid Services (CMS) continue to face substantial challenges

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