On or around April 20, 2015 CMS contractor TMF Health Quality Institute will release the third annual Program for Evaluating Payment Patterns Electronic Report (PEPPER) for SNFs—a resource characterized by both its unrivaled offering of free, comparative billing data and mediocre utilization by nursing home providers.
Free-standing SNFs and SNFs that are part of another type of hospital (3rd digit in the PTAN/CMS certification number/provider number = 5 or 6): Available electronically to the SNF’s CEO, president or administrator via www.pepperresources.org on April 20, 2015. You will see the screen shot below, click on the “distribution” button and then scroll down to the Skilled Nursing Facilities section and click on the “PEPPER Resources Portal”. On the next screen you will need to enter your demographic information including your 6-digit CMS Certification Number (also referred to as Provider Number or PTAN). The 3rd digit of this number will be a 5 or a 6.
Note: SNFs that are part of a critical access hospital will not receive PEPPER.
The goal of the PEPPER report is to provide provider-specific Medicare data statistics for discharges and services vulnerable to improper payments. PEPPER can support your compliance efforts by identifying facility specific outliers for targeted risk areas. This data can help identify both potential overpayments as well as potential underpayments.
Your therapy management team would like to assist with reviewing this information, please contact your manager for details.