Which activity is a ZPIC responsibility?

• A. Preventing, detecting, and deterring Medicare fraud.
• B. Providing direct patient care to Medicare beneficiaries.
• C. Setting Medicare reimbursement rates for hospitals.
• D. Conducting genetic research on disease prevalence.

Answer: (A)

ZPICs are part of CMS’s program integrity efforts. Their primary duty is preventing, detecting, and deterring Medicare fraud, waste, and abuse. They analyze billing data, identify suspicious patterns, and conduct audits and investigations to recover improper payments. Providing direct patient care, setting reimbursement rates, or conducting genetic research are not functions of ZPICs—they fall to clinicians, CMS policy processes, or researchers, respectively. So the activity that best fits a ZPIC responsibility is preventing, detecting, and deterring Medicare fraud.