Welcome To Monday Minute with Melinda! This week’s video will discuss the impact that PEPPER Reports can have on an agency.
Today I’d like to talk to you about the PEPPER Reports for both Home Health and Hospice. I want to begin by sharing a screen with you. This is the PEPPER location for the actual PEPPER Reports. Once you get to this website, you will scroll down and select the one that you’re here for, this is hospice, and if you go farther down, you’ll be at Home Health. These PEPPER Reports have been issued now for a few years, they’re updated annually. For Hospice, they are updated in April. For Home Health, they are updated in July. The PEPPER Reports are very specific to detailed calculated targets that come from your claims data. Whether it’s Home Health, or Hospice claims data is all that is used to calculate the targets.
When calculating the targets and they calculate the actual scores for your agencies, they are going to compare your scores to the 80th percentile of the nation. If your agency scores are higher than the 80th percentile of the nation, then there is a possibility that you could be targeted for additional medical review, whether that’s through ADRs or Targeted Probe and Educate which started again in September, earlier this month. Whether it’s a target by a UPIC auditor or the OIG. It is very, very important that you have reviewed your PEPPER Reports, again, whether your Home Health or Hospice, and ensure that someone within your organization is looking at any of your targeted scores that are in the 80th percentile or higher, or even approaching the 80th percentile to determine if there are things that can be done to avoid the scores being high. You also want to take into account that again, all of these scores come from your client’s data. In some cases, especially with hospice, there may be things that are actually being done incorrectly on the claims that could trigger those targets to be calculated higher than they actually should be. So you’re going to want to take a look at those. These PEPPER Reports are being looked by every review organization related to Medicare. So if you’re not looking at them, everybody you don’t want to look at them is and it could definitely cause you problems. There was a recent PEPPER Hospice Webinar that was done by the National Association for Home Care and Hospice. And there is one for Home Health PEPPER Reports also through the National Association for Home Care and Hospice, and we will provide the link to that in our Minute today.
Thank you all for joining us today. We do always appreciate your attention to the information that we provide. As always, we encourage you to stay tuned in to your State and the National Association for Home Care and Hospice and all of the data that they are there to provide. Also, there are things being sent out by the State and National Association asking for your help in terms of advocacy with our representatives, and we encourage you to participate in that fully. Thank you again and we will talk again soon.