Have You Accessed Your PEPPER Report?

Mary Madison, RN, RAC-CT, CDP 
Clinical Consultant – Briggs Healthcare

Yesterday, July 24th, I spotted an email from the PEPPER team in my inbox asking this very question. I receive frequent emails from PEPPER, depending on the time of year and the post-acute entity involved in the specific PEPPER message so yesterday’s email wasn’t a surprise. I always read such emails, so I dove right into this one. Here’s what I saw:

“The PEPPER team has updated the maps that display the PEPPER retrieval rates for PEPPERs accessed via the PEPPER Resources Portal for each state/territory. Percentages reflect the PEPPER release for SNFs, CAHs, Hospices and LTCHs that was completed April 5, 2019; and for HHAs that was completed July 8, 2019. Please click on a link below to view the maps. States on the interactive maps are color-coded according to their retrieval rates. Click on a state to obtain details such as the number of PEPPERs available in the state via the portal, the number of PEPPERs accessed via the portal, the retrieval rates and a link to the data file for all states/territories in the nation. The maps are updated monthly.”

There were some additional messages and hyperlinks in between the above and what the email said (below – bolding and italics are added by me; I’ll share those hyperlinks shortly…keep reading):

“PEPPER is an educational tool that summarizes provider-specific data statistics for Medicare services that may be at risk for improper payments. Providers can use the data to support internal auditing and monitoring activities. Visit PEPPER.cbrpepper.org to access resources for using PEPPER, including user’s guides, recorded web-based training sessions and a sample PEPPER. PEPPER is distributed by the PEPPER Team under contract with the Centers for Medicare & Medicaid Services.”

After reviewing the email, I accessed the SNF PEPPER Retrievals – PEPPER Resources Portal map. I’ve looked at it before, but yesterday’s viewing was the surprise – there are a number of states in which NO SNF facilities have accessed their PEPPER report for this year. The SNF PEPPER reports were released the 1st week of April and these states had NO SNF facility access their report yet! 10 states and 1 territory are identified by color coding as having 0 – 19% of SNF facilities accessing their report yet and it’s July. Clicking on individual states netted 7 of the 11 as being 0% retrievals by any SNF in that state. I checked another PAC entity’s map – CAH (Critical Access Hospital) – out of curiosity as the CAH PEPPER reports were also released in early April this year. 7 CAHs have yet to access their PEPPER report out of 10 states that fall into the 0 – 19% range as of this month.

PEPPER is designed, as noted above, to be an educational tool as well as an auditing tool to use for risk analysis. It’s historical data that CMS/Medicare is looking at to determine what Medicare-reimbursed services may be at risk for improper payments made to providers. You should know your PEPPER data!! CMS is tasked with protecting the Medicare Trust Fund from fraud, waste, and abuse. The provision of PEPPER supports CMS’ program integrity activities. PEPPER resources and reports are available for these PAC providers:

Here are the hyperlinks to the retrieval maps by provider type:

Map of Q4CY18 HHA PEPPER retrievals by state

Map of Q4FY18 SNF PEPPER retrievals by state

Map of Q4FY18 Hospice PEPPER retrievals by state

Map of Q4FY18 LT PEPPER retrievals by state

Map of Q4FY18 CAH PEPPER retrievals by state

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A plethora of PEPPER resources are available for all of the above entities, including specific directions for retrieving your PEPPER report as well as FAQs, videos, national level data reports, training and help with understanding your report each year. I encourage you to take full advantage of this website with its resources as well as knowing your PEPPER data. You’ll be glad you did!