The Centers for Medicare & Medicaid Services (CMS) has made available free provider-specific comparative data reports for home health agencies (HHAs) nationwide. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) summarizes HHA claims data statistics for areas that may be at risk for improper Medicare payments:

  1. Average Case Mix
  2. Average Number of Episodes
  3. Episodes with 5 or 6 Visits
  4. Non-LUPA Payments
  5. High Therapy Utilization Episodes
  6. Outlier Payments

HHAs can use the data to support internal auditing and monitoring activities. PEPPER is a free report comparing an HHA’s Medicare billing practices with other HHAs in the nation, Medicare Administrative Contractor (MAC) jurisdiction and state. CMS has contracted with TMF® Health Quality Institute to develop and distribute the reports.

The HHA PEPPER is available to access electronically via the PEPPER Resources Portal. There is no registration or account creation necessary. To obtain your HHA’s PEPPER, the Chief Executive Officer, President, Administrator or Compliance Officer of the HHA should:

  1. Review the Secure PEPPER Access Guide.
  2. Visit the Distribution Schedule – Get Your PEPPER pageat PEPPERresources.org.
  3. Review the instructions and obtain the information required to authenticate access through the PEPPER Resources Portal (the HHA’s CMS certification number and a medical record number or patient control number from a traditional Medicare Part A fee-for-service claim for services provided between December 1-31, 2014).
  4. Access the PEPPER Resources Portal.
  5. Complete all the fields.
  6. Download your PEPPER.

For more information on the HHA PEPPER, such as the HHA PEPPER User’s Guideand a sample HHA PEPPER, please visit PEPPERresources.org. A WebEx training session introducing and reviewing the PEPPER is scheduled for July 30; for more information see here. Questions about PEPPER may be submitted through the Help Desk.