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News

Expect audits to get more aggressive

January 27, 2017Theresa Flaherty, Managing Editor

atlanta - When ZPIC auditors come calling, it's important not to throw up your hands in surrender because there's too much at stake, said healthcare attorney Ross Burris.“They can suspend your payments; they can revoke your status,” said Burris, a shareholder with Polsinelli. “That six-month revocation can turn into 12 months. You'll be shocked at the aggressive nature and authority of some of these contractors.”ZPIC audits are typically provider specific and contractors will...

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News

Regulatory review: Suspensions, overpayments and exemptions

April 15, 2016Liz Beaulieu, Editor

WASHINGTON - From a regulatory perspective, the first several months of 2016 have brought pain, and a little bit of relief, to HME providers.Among the pain points, says Wayne van Halem, is the new level of aggressiveness in the actions taken by the ZPICs. The contractors are handing out payment suspensions where, previously, they may have handed out overpayment demands, he says.“Some of the reasons for suspensions are ridiculous,” said van Halem, president of The van Halem Group. “Because...

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Editorial

The boogeyman is alive and well

September 25, 2012Guest Commentary

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. They have unlimited power and almost no oversight.Let me begin with a little background. American Medical Technologies, a d/b/a of Gordian Medical, has been supplying surgical dressings to Medicare beneficiaries in long-term-care facilities since...

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News

OIG: Conflict of interest among potential ZPICs

July 11, 2012HME News Staff

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...

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Editorial

We survive an audit, so can you

November 23, 2010Sam Jarczynski

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. We have been in business for 14 years and, compared to other DME companies, we use a lot of technology. We maintain all of our patient information in a custom-built computer database, and we document all patient and physician contact in that database. We belong to AAHomecare,...

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News

Not all auditors are created equal

August 26, 2010Theresa Flaherty, Managing Editor

YARMOUTH, Maine - Billing consultant Sylvia Toscano has a word for providers who get hit with a ZPIC audit: ZPICed. "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." ZPIC audits have been taking place in...

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Editorial

Letter to the editor

July 22, 2010HME News Staff

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. 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...

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On the Editor's Desk

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

June 30, 2010Liz Beaulieu, Editor

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...

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