The National Alliance for Care at Home is beginning a national effort to better understand provider experience with UPIC (Unified Program Integrity Contractor) audits in home health. This work is focused on identifying common audit triggers, scope, and administrative impact on agencies, with the goal of informing future education and advocacy.
For many agencies, UPIC audits can be time-intensive and disruptive. These reviews are designed to identify potential fraud, waste, or abuse in Medicare and Medicaid programs, but providers often report significant operational strain tied to document requests, timelines, and the staff time needed to respond.
This outreach is intended to capture real provider experience so future education and advocacy efforts are grounded in what agencies are actually facing.
The effort is aimed at understanding what may trigger these audits, how broad they tend to be, and what kinds of administrative and financial pressure they create. That includes the volume of records requested, the time required to respond, and the broader impact on agency operations.
HCA is assisting in identifying Massachusetts agencies that have recently undergone a UPIC audit and may be willing to share their experience. Provider input will help ensure that future guidance, education, and advocacy reflect the realities on the ground.
If your agency has been subject to a UPIC audit and you are open to connecting, please reach out to Colleen Pierro directly.
