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OIG: Conflict of interest among potential ZPICs

OIG: Conflict of interest among potential 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).

The OIG reviewed conflict-of-interest information for 18 such companies, called offerors, and 85 subcontractors and found that, while many had business and contractual relationships with CMS and other offerors, they didn't consider them conflicts of interest. They reported having relationships with CMS or contractors of CMS that provide Medicare Parts C and D plans, claims processing, program integrity, and/or quality improvement services.

Currently, CMS requires that offerors disclose information about possible conflicts, but it does not have a formal policy for reviewing that information, according to the OIG.

As a result, the OIG recommends, among other things, that CMS:

provide clearer guidance in RFPs regarding which business and contractual relationships should be identified as actual conflicts and which should be identified as possible conflicts;

state whether offerors and subcontractors need to report income amounts, periods of performance, and types of work performed for their contracts with CMS and income amounts generated from key personnel's other employment; and

create a standardized format for reporting information in the organizational conflict of interest certificate and require its use by offerors and subcontractors.

To read the OIG's report:


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