Unified Program Integrity Contractor (UPIC) Announced

CMS has awarded the first Unified Program Integrity Contractor (UPIC) jurisdiction, Midwestern, to AdvanceMed, a wholly owned subsidiary of NCI, Inc. The UPIC statement of work combines and integrates the functions of the former Zone Program Integrity Contractor (ZPIC), Program Safeguard Contractor (PSC) and Medicaid Integrity Contractor (MIC) contracts into a single contract. UPIC Midwestern Jurisdiction is scheduled to be fully operational on October 20, 2016. Under this award, AdvanceMed will perform fraud, waste and abuse (FWA) detection and prevention activities for Medicare and Medicaid claims processed within the Midwestern Jurisdiction. This covers the states of Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Missouri, Nebraska, Ohio and Wisconsin. AdvanceMed will focus on analysis of managed care encounter and fee for service claims data, and coordination with appropriate partners for referral and resolution of identified issues for Medicare and Medicaid programs. AdvanceMed’s specific work will include lead screening; investigation; medical review; remedy implementation; and collaboration with CMS, federal, state and local government, law enforcement, and other CMS partners and contractors.