US · guidance
CMS Pub. 100-08, ch. 1, § 1.7
Program Integrity
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).
History
(Rev. 12772; Issued: 08-09-24; Effective: 09-20-24; Implementation: 09-20-24)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
f15cf00a194e8549896a19962e1829267fac86bae28328a02f1197db35cff744
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