Other Issuances: CAHs to receive PEPPER data, OIG audits device replacement
Medicare Weekly Update, December 21, 2010
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TMF announces PEPPER updates
TMF announced several updates to the Program for Evaluating Payment Patterns Electronic Report (PEPPER), including new PEPPER data for critical access hospitals, inpatient psychiatric facilities, and inpatient rehabilitation facilities starting in 2011.
TMF is also making several changes to the next short-term acute care hospital PEPPER, including:
- Interpretive guidance included on each target area worksheet
- Suggested interventions if the hospital is at/above the 80th percentile or at/below the 20th percentile (coding-focused target areas only) included on each target area worksheet
- Improved labeling of time periods on the target area worksheets and graphs
OIG audits outpatient device replacement
On December 6, the OIG posted a review of outpatient claims for procedures that included the replacement of medical devices from Massachusetts General Hospital. The OIG determined that the hospital did not fully comply with Medicare requirements for obtaining credits available from manufacturers for replaced medical devices and for reporting the appropriate modifier and charges to reflect the credits received, resulting in overpayments of $63,000 and increased beneficiary costs.
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