Home Health Agencies (HHAs) will have a “free” tool available to help them assess their risk of improper Medicare payments beginning July 2015. TMF Health Quality Institute is developing a new Program for Evaluating Payment Patterns Electronic Report (PEPPER) for HHAs. PEPPER is an educational tool to help providers proactively monitor their claims and work to prevent improper Medicare payments. It summarizes an HHA’s Medicare claims data in areas that may be at risk for improper Medicare payments and compares the HHA’s statistics with aggregate statistics for the nation, MAC jurisdiction and the state. If a provider’s statistics are at or above the national 80th percentile, the provider is identified as an “outlier” and may be at risk for improper Medicare payments.
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