Catch and prevent improper payments with Medicare's Program for Evaluating Payment Patterns Electronic Report (PEPPER). Both home health and hospice agencies can access their reports through the PEPPER Portal.
These comparative billing reports summarize Medicare claims data to help agency Chief Executive Officers, Presidents, Administrators & Compliance Officers identify payment patterns at their own agencies and compare them with state, regional, and national reports.
Target areas that PEPPERs tally for hospice providers include live
discharges, long length-of-stay (180+ days), continuous and routine home care in assisted living facilities, and routine home care in nursing facilities and skilled nursing facilities. In addition, hospice PEPPERs track, for each of the top terminal conditions, the total number and percentage of decedents, as well as average length of stay.
discharges, long length-of-stay (180+ days), continuous and routine home care in assisted living facilities, and routine home care in nursing facilities and skilled nursing facilities. In addition, hospice PEPPERs track, for each of the top terminal conditions, the total number and percentage of decedents, as well as average length of stay.
Target areas that PEPPERs tally for home health providers include average case mix, average number of episodes, 5-6 visit episodes, non-LUPA payments, and outlier payments. In addition, home health PEPPERs track the proportion of episodes with each of the top principal diagnoses, as well as the total number of visits and average number of visits per episode bearing that primary diagnosis, including designations that indicate high-therapy utilization in early and late episodes. Find user's guides, training materials, and registration access for home health and hospice PEPPERs at the PEPPER Resource site.