Attention Home Health Agencies: PEPPER Update Session Scheduled

As we previously reported, the TMF Health Quality Institute is developing a new Program for Evaluating Payment Patterns Electronic Report (PEPPER) for Home Health Agencies (HHA). It will be available this July.

TMF Health Quality Institute has provided the following details regarding a PEPPER update session on April 30:

When: Thursday, April 30 at 11:00 a.m. to 12:30 p.m. Central Daylight Time

What: A WebEx presented by Kimberly Hrehor with TMF Health Quality Institute

Topic: An update on what is new/changed in the Q4FY14 PEPPER for Skilled Nursing Facilities (SNFs), Long-term (LT) Acute Care Hospitals, Inpatient Rehabilitation Facilities (IRFs) and Hospices, and a preview of the Home Health Agency PEPPER (coming in July 2015).

Registration is not required! Use this link to join the event:

Event number: 923 918 378

Event password: lantana

This program is being brought to you at no charge.

Handout: Will be posted on the website on the applicable Training and Resources pages by April 29, 2015.

Click here for more information.


PEPPER To Be Available For Home Health Agencies

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.

Click here to read more.

New Hospice PEPPER Report To Be Released In April

In 2012, CMS began development and release of Program for Evaluating Payment Patterns (PEPPER) reports for Medicare-certified hospices through its PEPPER contractor, TMF Health Quality Institute. As part of the PEPPER process, certain “target areas” within the Medicare hospice benefit that could be at risk for improper payment are identified, and the data related to target areas is analyzed. The PEPPER reports “supply an individual hospice’s data over three years’ time and also provide, for comparison, the same data for hospices, nationally, within the same Medicare Administrative Contractor (MAC) jurisdiction, and within the same state as the subject hospice.” The data allows a hospice to assess its performance and risks in the target areas. Starting in April, PEPPER reports are becoming available by way of an electronic PEPPER Resources Portal. TMF Health Quality Institute is expected to release the latest hospice PEPPER in mid-April. The PEPPER target areas for hospice have also been expanded.

Click here to see them and for more information from NAHC.

Click here to see the fourth edition of the PEPPER Hospice User’s Guide.

Free Hospice-Specific Data Reports Available From CMS

Beginning in late August 2012, the Centers for Medicare & Medicaid Services (CMS) will make free hospice-specific comparative data reports available for hospices nationwide.

The Program for Evaluating Payment Patterns Electronic Report (PEPPER) includes hospice-specific data statistics for Medicare claims that may be at risk for improper Medicare payments. Hospices can use the data to support internal auditing and monitoring activities.

Click here to read more.