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Home News

CMS Awards Anti-fraud Services Contracts

by The O&P EDGE
January 3, 2022
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The Centers for Medicare & Medicaid Services (CMS) has awarded positions on a potential ten-year, $2.5 billion contract 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 developed the UPIC program to improve the efficiency of and consolidate the work carried out by Zone Program Integrity Contractors (ZPICs), Program Safeguard Contractors (PSCs), Medicare-Medicaid Data Match (Medi-Medi) programs, and Medicaid Integrity Contractors (MICs). UPICs will conduct Medicare, Medicaid, and Medi-Medi investigations and audits within designated geographic jurisdictions.

CMS announced its selections of the contractors in a series of FedBizOpps and will award task orders for services across five geographic areas with multiple states as defined by CMS, according to the GovConWire website.

Awardees and their respective contract award dollar amounts include:

  • AdvanceMed, Reston, Virginia, $76,874,623.22
  • Health Integrity, Easton, Maryland, guaranteed minimum – $25,000, estimated maximum $2.5 billion
  • IntegriGuard dba HMS Federal, Omaha, Nebraska, guaranteed minimum – $25,000, estimated maximum $2.5 billion
  • Noridian Healthcare Solutions, Fargo, North Dakota, guaranteed minimum – $25,000, estimated maximum $2.5 billion
  • Safeguard Services, Plano, Texas, guaranteed minimum – $25,000, estimated maximum $2.5 billion
  • StrategicHealthSolutions, Omaha, guaranteed minimum – $25,000, estimated maximum $2.5 billion
  • TriCenturion, Columbia, South Carolina, guaranteed minimum – $25,000, estimated maximum $$2.5 billion

The first UPIC first task order was awarded to AdvanceMed for services in the contract vehicle’s Jurisdiction 1 area that encompasses Minnesota, Wisconsin, Illinois, Indiana, Michigan, Ohio, Kentucky, Iowa, Missouri, Nebraska, and Kansas.

Related posts:

  1. The RACs Are Coming: Preparing for Medicare Claims Denials of O&P Care
  2. CMS’ Annual RAC Update at Odds with Reality for O&P Community
  3. New Medicare Supplier Enrollment Rules Include Stiff Penalties
  4. CMS Announces Competitive Bidding Final Rule, First MSAs
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