PEPPER: Program for Evaluating Payment Patterns Electronic Report
PEPPER has come to home health. The first set of statistics are going to be made available through December 2014. The report gives Medicare providers information about their payment patterns that could appear as improper. Data and statistics to be made available will be a great resource to help Quality Assurance departments analyze information and identify any potential abuse.
To get your agency’s PEPPER please go to: http://www.pepperresources.org/ and then follow the instructions on the site to obtain your report. You will need to do this multiple times if you have more than one provider number.
Tips to access your PEPPER:
Have a claim available from December 1 – December 31, 2014. You will need your agency’s certification number and a patient control number from the claim you pulled for the period.
The report will be available as an Excel file so you may analyze the data. Please let us know if you would like us to help you analyze the data or arrange the information in an easy to read format, to make sure your agency staff understand the importance of PEPPER data.
Quality Assessment Only (QAO) – Home Health Quality Reporting
Beginning July 1st, CMS will be using data from OASIS submissions to comply with 2015’s Final Rule. The ‘Pay-for-Reporting Performance Requirement’ requires agencies to submit OASIS data. Those that do not, will be subject to a 2% annual payment update (APU) reduction for calendar year 2017.
Agencies have from July 1, 2015 through June 30, 2016 to be 70% compliant. Failure to do so will trigger the APU reduction in 2017.
To view your agency’s compliance with OASIS submissions, login to your CASPER account and check the shared folder. The data to verify you compliance will be available until October 26, 2015.
OASIS C1/ICD-10 Manual is Available
The revised OASIS C1/ICD-10 Manual is now available on CMS’ website. The manual can be obtained here: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/HHQIOASISUserManual.html