Training & Resources for Hospice
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Current PEPPER User's Guide:
- View a list of the 4 MAC jurisdictions and the number of hospices in each jurisdiction in total and by state for PEPPER version Q4FY12 (36 KB XLS).
- View a list of the 4 MAC jurisdictions and the number of hospices in each jurisdiction in total and by state for PEPPER version RY2011 (26 KB XLS).
Hospice PEPPER Training Update - March 2013
PEPPER Training (September 13, 2012):
- Hospice PEPPER Training: Session 1 – This session reviews the new PEPPER for Hospices. It includes the history and background of PEPPER, and a description of the areas at risk for improper Medicare payments. It also discusses percents and percentiles and the comparison groups.(Duration: 29:42, requires Flash 10.0 or later)
- Hospice PEPPER Training: Session 2 − This session is a demonstration of a Hospice PEPPER and reviews the reports included, and provides a discussion on how the PEPPER can be used. (Duration: 33:08, requires Flash 10.0 or later)
- Access alternate file formats and a transcript of this training.
- Download the PowerPoint slides (641 kbs, PDF) for the Hospice PEPPER training session.
- View questions and answers (111 kbs, Word) from the September 13, 2012 Hospice PEPPER training session.
- Hospice question and answer session audio: This question and answer session, held on October 4, 2012, addresses provider questions about PEPPER for Hospices. (Duration: 52:12, mp3, requires multimedia player).
- Access a transcript (72 kbs, Word) of the October 4, 2012 Hospice PEPPER question and answer session.
What is PEPPER?
The Hospice PEPPER is a report that summarizes a hospice’s Medicare claims data in areas that may be at risk for abuse or improper payment. PEPPER compares a hospice’s claims data statistics with aggregate statistics for other hospices in the state, MAC/FI jurisdiction and the nation. Hospices with high billing patterns (at or above the national 80th percentile) are identified as at risk for improper Medicare payments and are encouraged to ensure that they are complying with Medicare payment policy, that services provided to beneficiaries are medically necessary and that medical record documentation supports the services that are billed.
PEPPER cannot identify the presence of improper payments. Only a review of the medical record can determine whether services are medically necessary and appropriately billed.
TMF will distribute PEPPER according to this schedule and methods.
- Demonstration PEPPER version Q4FY12 (1 MB XLS, updated 4/29/2013)