What role do ZPICs play in the context of Medicare and Medicaid?

ZPICs, or Zone Program Integrity Contractors, are specialized contractors that play a critical role in safeguarding Medicare and Medicaid programs. Their primary responsibility is to conduct audits to identify and address potential overpayments made to healthcare providers. This involves reviewing claims, identifying discrepancies, and determining whether payments were made appropriately according to established guidelines and regulations.

By focusing on the detection of fraudulent activities and improper billing practices, ZPICs help ensure that resources are not wasted and that the integrity of Medicare and Medicaid programs is maintained. Their work is essential in protecting government healthcare funds and ensuring that beneficiaries receive proper care without the influence of malfeasance.

The other options do not accurately reflect the specific functions of ZPICs. They are not healthcare providers, nor do they provide legal services or manage patient records. Instead, their main function revolves around the financial accountability of covered services, making the conduct of audits for overpayments their defining role.