Health Information Management

Use PEPPER to enhance your RAC readiness

HIM-HIPAA Insider, June 21, 2011

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Not sure where to focus your RAC preparations these days? Look no further than the Program for Evaluating Payment Patterns Electronic Report (PEPPER) to add a little spice to your compliance efforts.

The report, published by TMF® Health Quality Institute under contract with CMS, shows short-term acute care hospitals how their data for 29 target areas compares with others in three categories: state, Medicare Administrative Contractor/FI jurisdiction, and nation. The 29 targets include 18 that are new for 2011; they're based on feedback from hospitals and the RAC demonstration and expansion projects.
 
PEPPER is now available for critical access hospitals as well. The PEPPER for inpatient psychiatric facilities will be released this month, and the PEPPER for inpatient rehabilitation facilities will be released in September. These annual reports will include setting-specific areas prone to improper Medicare payments.
 
"Improper payments occur in all types of Medicare providers," says Kimberly Hrehor, MHA, RHIA, CHC, project director at TMF Health Quality Institute in Austin, TX. "While currently the majority of the focus is on short-term acute care hospitals, regulatory contractors will likely begin to look at these other settings in attempts to identify Medicare over- and underpayments," she says.
 
Editor’s note: To read more, access this article in the June issue of Briefings on Coding Compliance Strategies.



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