Unified Program Integrity Contract (UPIC)

The Unified Program Integrity Contract (UPIC) is a multiple-award Indefinite Delivery/Indefinite Quantity (IDIQ) contract vehicle established by the Centers for Medicare & Medicaid Services (CMS) to consolidate and streamline program integrity functions across Medicare and Medicaid. The contract aims to enhance the government's capacity to detect, investigate, and prevent fraud, waste, and abuse in healthcare programs through integrated data analysis, proactive monitoring, and comprehensive investigative services. By combining previously fragmented contractor efforts into a single strategic vehicle, CMS can more effectively adapt to emerging healthcare fraud challenges and improve overall program integrity.

The UPIC has been awarded to multiple prime contractors, including Qlarant Integrity Solutions LLC, Noridian Healthcare Solutions LLC, Safeguard Services LLC, and Coventbridge USA Inc., each managing specific jurisdictional task orders. Typical task orders range from $217 million to $334 million, with performance periods spanning approximately 7-10 years, and are consistently structured as cost-plus-award-fee or cost-plus-fixed-fee contracts. The task orders cover diverse geographical jurisdictions (Western, Southwestern, Southeastern, Northeastern, and Midwestern) and involve critical activities such as claims review, improper payment rate reduction, Medicare drug integrity contractor services, and proactive data analytics. None of the observed task orders utilized small business set-asides, indicating full and open competition. The primary focus remains on supporting CMS's mission of protecting federal healthcare program expenditures through sophisticated investigative and analytical approaches.