LeadingAge Submits Response to RFI on PEPPERs

LeadingAge submitted a response to a Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on the Program for Evaluating Payment Patterns Electronic Reports (PEPPERs). A PEPPER is an electronic report that delivers provider-specific Medicare statistics for discharges and services vulnerable to improper payments. Home health, hospice, and skilled nursing facilities are all settings which previously received these reports prior to CMS temporarily pausing the program in January.

PEPPERs are used to educate providers by showing them how they compare to their peers and alert them of potential over-utilization and potential payment errors. LeadingAge's response focused on making sure the language used in the reports is for providers, not auditors. Many of the reports discuss "targets" which to a provider could mean something to work towards, but the opposite is true in the reports since they are geared more towards auditors looking at "targets" for aberrant billing.

Overall, members shared that the reports are very useful but need to be revised to make them more user friendly. CMS expects these reports to be re-released in the fall of 2024, LeadingAge will keep members updated on any new information.