On the Hunt for Fraud: ZPIC Audits (Medicare)

If you are audited by a Zone Program Integrity Contractor (ZPIC), it may mean a Medicare contractor has identified potential fraud in your billing. The ZPIC in Florida is Safeguard Services, although other companies subcontract with them to help perform these audits. Stopping fraud is one of both Florida and the federal governments' highest priorities, and if a Medicare or Medicaid auditor concludes that fraud exists, criminal charges may be instituted. In addition, civil overpayments and/or suspension or revocation of Medicare or Medicaid numbers may occur. In addition, loss of Medicare or Medicaid certification for cause, or criminal fraud charges could lead to permanent loss of licensure.

 

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