11/09/2016

CMS Announces Region 1 Unified Program Integrity Contractor (UPIC)

CMS has awarded the first Unified Program Integrity Contractor (UPIC) jurisdiction, Midwestern, to AdvanceMed, a wholly owned subsidiary of NCI, Inc. CMS has awarded contracts on a potential ten-year, to seven companies for its Unified Program Integrity Contract (UPIC). Under this contract, the UPICs shall perform numerous functions to detect, prevent, and deter specific risks and broader vulnerabilities to the integrity of the Medicare and Medicaid programs. They will also coordinate activities with CMS and other agencies at the federal, state, and local government levels, as well as with other CMS partners and contractors.

CMS established the UPIC program to consolidate the work carried out by

• Zone Program Integrity Contractors (ZPICs)
• Program Safeguard Contractors (PSCs)
• Medicare-Medicaid Data Match (Medi-Medi) programs
• Medicaid Integrity Contractors (MICs)

The UPIC will combine and integrate these existing functions into a single contractor in a defined geographic area (UPIC Jurisdiction) performing Medicare and Medicaid program integrity work on behalf of CMS.

UPIC Midwestern Jurisdiction, which includes Ohio, Michigan, Indiana, Kentucky, Wisconsin, Missouri, Iowa, Minnesota, Nebraska and Kansas, is scheduled to be fully operational on October 20, 2016.

To learn more about AdvanceMed and their role in fraud prevention, click here.