Program Integrity

1.7 - Program Integrity (Rev. 12772; Issued: 08-09-24; Effective: 09-20-24; Implementation: 09-20-24) A. Contractors to Which This Section Applies This section applies to UPICs only. B. General In addition to reducing improper payments, CMS strives to protect the program from potential fraud. CMS contracts with Unified Program Integrity Contractors (UPICs) to identify and stop potential fraud. The primary task of UPICs is to identify cases of suspected fraud, develop them thoroughly and in a timely manner, and take immediate action to ensure that Medicare Trust Fund monies are not inappropriately paid out and that any mistaken payments are identified. UPICs shall refer cases of potential fraud to the Department of Health and Human Services (HHS) Office of Inspector General (OIG) Office of Investigations (OI).