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Collection Status of ZPIC and PSC – Identified Medicare Overpayments

OIG issued several reports regarding the tracking and collection of overpayments that Medicare’s contractors have made to providers. In response, Centers for Medicare & Medicaid Services stated that it added reporting requirements that would improve overpayment tracking among the claims processors and Zone Program Integrity Contractors (ZPICs) and Program Safeguard Contractors (PSCs). ZPICs and PSCs are required to detect and deter fraud and abuse in Medicare Part A and Part B in their jurisdictions. They conduct investigations, refer cases to law enforcement, and take administrative actions such as referring overpayments to claims processors for collection and return to Medicare. We will determine the total amount of overpayments that ZPICs and PSCs identified and referred to claims processors in 2014 and the amount of these overpayments that claims processors collected. We will also review the procedures for tracking collections of overpayments identified by ZPICs and PSCs.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Nov-16 Centers for Medicare & Medicaid Services Collection Status of ZPIC and PSC – Identified Medicare Overpayments Office of Evaluation and Inspections OEI-03-13-00630 2017

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