Healthcare Fraud Contracts

ZPIC 4 Contract

CES partners with Health Integrity LLC on ZPIC 4, the first Zone Program Integrity Contract awarded by the Centers for Medicare & Medicaid Services (CMS). CES investigators focus on the identification, detection, and investigation of fraud, waste and abuse issues in Texas, Oklahoma, Colorado, and New Mexico in Medicare Parts A, B, DME, Home Health and Hospice (HH&H) and the Medi-Medi program for Texas, Colorado, and Oklahoma.

ZPIC 5 Contract

CES partners with Advance Med on ZPIC 5 where we provide nurse reviewers who focus on a all aspects of fraud, waste and abuse issues in states of Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia.

NBI MEDIC Contract

CES partners with Health Integrity to provide investigative services on the National Benefit Integrity Medicare Drug Integrity Contract (NBI MEDIC). The MEDIC contract focuses on the Medicare Part C and D programs. CES supports this contract with investigators located in offices Gilbert, AZ, Los Angeles, CA, Miami, Orlando, Tampa, St. Augustine, FL, Atlanta, GA, Chicago, IL, Kansas City, KS, New Orleans, LA, Baltimore, MD, Detroit, MI, Greensboro, NC, Brick, NJ, Galena, OH, Pittsburgh, PA, Dallas, McAllen, San Antonio, TX and Puerto Rico.

Ohio, Kentucky, Minnesota PSC Contract

CES partners with Advance MED to provide investigators and nurse reviewers who focus on Part A and B issues in Ohio, Kentucky and Minnesota.

CMS MA and PDP Sponsors Audits Contract

CES partners with Clifton Gunderson to provide investigative services on the CMS MA and PDD Audits.