PEPPER reports for home health, hospice to be released in upcoming months
Homecare E-News, March 16, 2015
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On or around April 13, CMS contractor TMF Health Quality Institute will release the fourth annual Program for Evaluating Payment Patterns Electronic Report (PEPPER) for hospices.
The report—which is available in many settings along the healthcare continuum and which has been distributed to hospices since 2012—provides free, comparative billing data in setting-specific domains considered at potential risk for abuse or improper Medicare payment. Experts say the report can help providers flag potential problems in their billing practices and brace for audits.
Previous iterations of the hospice PEPPER have homed in on two target areas: live discharges and long lengths of stay. This year’s hospice PEPPER will be the first to also feature four new targets:
- Continuous homecare provided in an assisted living facility (ALF)
- Routine homecare provided in an ALF
- Routine homecare provided in a nursing facility
- Routine homecare provided in a skilled nursing facility
These additional focuses are largely based on recommendations from a January report by the Office of Inspector General, which found that hospices have a financial incentive to provide prolonged care to hospice beneficiaries in ALFs.
This July, TMF will also introduce the first PEPPER report for home health.
For more information about accessing and using PEPPER in the home health and hospice settings, click here, and stay tuned for the upcoming (April 2015) issue of Homecare DIRECTION.
This is an excerpt from a member only article. To read the article in its entirety, please login.
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