Zone Program Integrity Contractor

Zone Program Integrity Contractors (ZPIC) are contractors that the Centers for Medicare & Medicaid Services (CMS) hire to investigate possible fraud, waste and abuse within the Medicare program. They investigate suspicious billing patterns and conduct provider audits to ensure compliance with Medicare regulations. ZPICs also work to identify and prevent fraud, waste, and abuse by analyzing claims data, conducting provider audits and investigations, and working with law enforcement agencies to pursue criminal and civil charges. ZPICs operate within specific geographic regions, known as "zones," and are responsible for identifying and addressing issues within their assigned zone. They play an important role in ensuring the integrity of the Medicare program and protecting the interests of taxpayers and beneficiaries.