Providers on ZPIC audits: 'We will stand with Richard'


After we ran this story about Richard Lamb in our HME NewsWire this week, I got a handful of e-mails from anxious and angry providers who say they're going through the same thing. They're not quite closing their doors due to ZPIC audits, but they're wounded and limping in that direction.

Here's what Jeff Brast from Special Care Home Oxygen had to say:

We went through one of these audits at the beginning of the year and did not get paid for about eight weeks. We are still trying to dig out of the havoc this caused. Try running a business with no income. This is just another back channel way to thin the herd. It seems as though CMS will not rest until they have only a handful of providers. All in the name of saving money, supposedly. Far from it. When there are only a few providers left, you will have a defacto cartel. Does the name OPEC ring any bells? When CMS "achieves" this end game and tries for yet more reductions in reimbursements, what do you think will happen? We will stand with Richard; he has our support.

Here's what Dee O'Dell at M&M Mobility and Medical/Premier Medical had to say:

We are in a similar situation with the ZPIC contractor and I would like to have an opportunity to provide some additional information as soon as possible regarding Health Integrity and their admitted inability to handle the submitted documentation, which is resulting in denials against DMEs. Please contact me ASAP. Our company and livelihood are at stake because of their mistakes!

There were a handful of other e-mails, including this one from an unnamed provider:

Well (the audits) just keep going!!! 30 days? No 45?  60? 90?  Forever?  We are suspending services temporarily and will be laying off 3/4s of the staff this weak. This is communism or worse!

In addition to sharing their stories with HME News, however, providers need to share them with AAHomecare. The association is collecting examples of how the ZPIC audits, and to a lesser extend the CERT and RAC audits, are "unreasonable, unrealistic and a significant burden on providers." So drop Walt Gorski a line at

The ZPIC audits may be a "sleeper issue" due to everything else going in the HME industry (competitive bidding and PECOS just to name two) and due to their, at this point, limited scope (they're only taking place in Texas and Oklahoma).

But this is something that the industry is going to want to nip in the bud before other providers become sacrificial lambs.

Liz Beaulieu


There is hope!

If you have been audited by a ZPIC or RAC and they have hit you with an extrapolated overpayment demand Bruce Kardon, PhD can help you. Dr. Kardon was hired by HCFA in the 1990s to create the statistical method by which Medicare could perform sample audits and project those denials across the universe of all claims previously paid. NOW he's on your side. Why? Because ZPICs and RACs are failing to use methods that are in adherence with Generally Accepted Statistical Principles. Dr. Kardon now analyzes the data of ZPIC/RAC Extrapolated Overpayment Demands and testifies on behalf of the Provider/Supplier as an Expert during their Appeal. In all the cases Dr. Kardon has so far testified, the Judge has either substantially reduced the amount of overpayment or in some instances completely thrown out the entire Extrapolated Amount. They simply aren't doing it right!

You can reach Dr. Kardon at P.O. Box 653 Clemmons, NC 27012 (336)766-5608 or visit his website at