Zone Program Integrity Contractors are associated with which activity?

Zone Program Integrity Contractors are associated with which activity?

• A. Blue Cross Blue Shield
• B. Independent Contractors
• C. Zone Program Integrity Contractors
• D. American Medical Contractor

Answer: (C)

Zone Program Integrity Contractors are the entities CMS designates to carry out program integrity work in Medicare and Medicaid. Their role is to prevent and detect fraud, waste, and abuse by conducting audits, investigations, and data analysis within their assigned zones. This is the activity that matches their purpose: performing program integrity tasks to safeguard program dollars and ensure proper payments. Other options don’t fit because they don’t represent the CMS-specific function of overseeing integrity work (Blue Cross Blue Shield is a private insurer, and the others are not CMS program integrity contractors or are too generic).

Zone Program Integrity Contractors are the entities CMS designates to carry out program integrity work in Medicare and Medicaid. Their role is to prevent and detect fraud, waste, and abuse by conducting audits, investigations, and data analysis within their assigned zones. This is the activity that matches their purpose: performing program integrity tasks to safeguard program dollars and ensure proper payments. Other options don’t fit because they don’t represent the CMS-specific function of overseeing integrity work (Blue Cross Blue Shield is a private insurer, and the others are not CMS program integrity contractors or are too generic).