CMS Unified Program Integrity Contractor (UPIC)

To detect, prevent, and proactively deter fraud, waste, and abuse in Medicare and Medicaid Programs. Under UPIC as a subcontractor to Qlarant, we perform functions to reduce fraud, waste, and abuse (FWA) in both the Western and the Southwestern geographic areas or “jurisdictions". Notably, applying Certified Medical Coding Subject Matter Expertise (SME) to help identify improper payments. Under CMS direction, Qlarant will perform various functions to detect, prevent, and deter specific risks to the integrity of the Medicare and Medicaid programs. These vulnerabilities may be a result of billing approaches, program changes, or innovations (e.g., use of electronic medical records). The UPICs are required to perform their work in compliance with all federal and state laws and regulations, CMS requirements, and Medicare and Medicaid manuals.

The purpose of this contract is to provide strategic, technical, and program management guidance and support services, to facilitate the modernization of CMS business processes and supporting systems. Contact us to learn more: