Zone Program Integrity Contracts (ZPIC)
In 2008, CMS began the process of consolidating the scope of all Program Safeguard Contractor (PSC) and Medicare Prescription Drug Integrity Contractor (MEDIC) contracts into ZPIC contracts. The ZPIC contracts include work for all claim types including Part A, Home Health, Hospice, Part B, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS), Managed Care (Part C), Part D Medicare Prescription Drug, and Medicare and Medicaid Data Matching. Part A cost report audit and reimbursement will also added under the scope of a ZPIC contractor.
- Zone 1 ZPIC - California, Nevada, American Samoa, Guam, Hawaii, and the Mariana Islands.
- Zone 2 ZPIC - Alaska, Washington, Oregon, Montana, Idaho, Wyoming, Utah, Arizona, North Dakota, South Dakota, Nebraska, Kansas, Iowa and Missouri.
- Zone 3 ZPIC - Minnesota, Wisconsin, Illinois, Indiana, Michigan, Ohio, and Kentucky.
- Zone 4 ZPIC - Colorado, New Mexico, Oklahoma, and Texas.
- Zone 5 ZPIC - Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia.
- Zone 6 ZPIC - Pennsylvania, New York, Maryland, Washington D.C., Delaware, Maine, Massachusetts, New Jersey, Connecticut, Rhode Island, New Hampshire, and Vermont.
- Zone 7 ZPIC - Florida, Puerto Rico and Virgin Islands. Contract awarded to SafeGuard Services, LLC on September 30, 2008.
The Statement of Work (SOW) for ZPIC contracts are similar to the existing SOW for the PSC and MEDIC, therefore an award of a ZPIC does not change the process and procedures used by SGS. An award expands the scope of work to include additional claim types and in some instances expands the region of the contract. SGS will use its existing process procedures and systems to support ZPIC work.