Children are sometimes threatened with the boogeyman to ensure good behavior. Someone at CMS remembered this and has applied the same tactic to suppliers/providers. Only this time, it is not a threat, it is real: Zone Program Integrity Contractors or ZPICs.
WASHINGTON – Companies that seek ZPIC contracts from CMS often have conflicts of interest that could compromise the integrity of the program, according to a new report from the Office of Inspector General (OIG).
Just after the July 4 holiday, Rx Stat Inc. started getting letters from a ZPIC auditor. We thought we were safe. We don't cut corners with paperwork, and we only bill items after all of the required documentation is collected.
"The ZPIC auditors are voracious," said Toscano, owner of Boca Raton, Fla.-based billing firm Professional Medical Administrators. "If a provider specializes in a particular item, they will get ZPICed for that item. I have seen up to 1,000 letters sent (to a provider) in a 30-day timeframe. It's a cash strangle and an administrative nightmare."
We went through one of these audits at the beginning of the year and did not get paid for about eight weeks (“Provider survives cuts, recession only to fall victim to ZPIC audit,” HME News, August 2010). We are still trying to dig out of the havoc this caused.