NCI Inc., of Reston, Va., announced April 28 that the company’s AdvanceMed business was awarded the Zone Program Integrity Contractor (ZPIC) contract for Zone 3 in support of the Centers for Medicare and Medicaid Services (CMS). The one-year contract is valued in excess of $14 million. NCI will provide program integrity (PI) services to identify and reduce Medicare fraud in Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin.
“This award expands our current ZPIC work to a third zone and increases NCI’s Medicare program integrity support to a total of 31 states,” NCI President Brian J. Clark said. “We are proud to support CMS in its efforts to uncover and mitigate fraud, waste and abuse in the program and pleased this award resulted from our outstanding past performance and return on investment to our customer.”
Under this contract, NCI will perform PI investigations, make coverage and coding determinations, and implement administrative actions. The company will also assist CMS in developing a list of entities that may require future monitoring, and referring cases and supporting law enforcement in the investigation and prosecution of those cases. The company also will help coordinate potential fraud, waste and abuse mitigation activities.