Courtesy of the National Association for Home Care & Hospice (NAHC)

The Home Health Program for Evaluating Payment Patterns Electronic Report (PEPPER) is available for download on the PEPPER portal. This is the only mode of distribution of the reports.

PEPPER summarizes Medicare claims data statistics for a provider in “target areas” that may be at risk for improper Medicare payments. In addition, PEPPER compares the provider’s Medicare claims data statistics with aggregate Medicare data for the nation, Medicare Administrative Contractor (MAC) jurisdiction, and the state.

While the PEPPER cannot identify improper payments, it does help a provider to identify areas in which performance falls outside the norm and payments may be at risk. Percentiles are calculated for each of the three comparison groups (i.e., nation, jurisdiction, and state). The greater a home health agency's percentile, the greater risk for improper payments.

The PEPPER team has developed suggested interventions that providers could consider when assessing their risk for improper Medicare payments for each of the target areas.

There are two new target areas for home health this year: "Functional Impairment – Medium" and "Functional Impairment – High".