The annual SNF Program for Evaluating Payment Patterns Electronic Report (PEPPER) Report will be released in April of 2022.
The report shows how a SNF’s data for target areas (areas that could be at risk for improper payment) compares to aggregate jurisdiction, state, and national statistics. Statistics in PEPPER are presented in tabular form and in graphs that depict the SNF’s target area percentages. The data tables, graphs, and reports are designed to assist with the identification of potentially improper payments.
The PEPPER is developed under contract with the Centers for Medicare & Medicaid Services (CMS) by RELI Group along with its partners TMF Health Quality Institute and CGS Administrators.
The SNF PEPPER target areas and supplemental reports have been changing to provide information related to potential vulnerabilities of PDPM, rather than those areas that were vulnerable under the RUG payment system.
PEPPER data is accessible to the Provider, after certifying their authority to receive the PEPPER and all other confidential information concerning this health care provider, to one of the following:
- Compliance Officer
- Quality Assurance/Performance Improvement Officer
To access your facility’s PEPPER data, you need to log on to the PEPPER Resources Portal at:
Steps to access PEPPER:
- Enter Authorized Agent First and Last Name
- Email Address
- Provider Name
- Provider City
- Provider State
- Provider Type
- Enter the Facility’s CMS Certification Number (also referred to as Provider Number or PTAN)
- The third digit of your six digit CMS certification number (CCN, Provider Number, PTAN) will be a “5” or “6”.
- Enter a Validation Code.
- The Validation Code is either a Patient Control Number or Medical Record Number found at form locators 03a or 03b on the UB-04 claim form of a Traditional Fee-For-Service Medicare beneficiary who received services during the specified time period. The specified time period will be the “from” or “through” date between July 1, 2021-September 30, 2021.
- An alternative option for obtaining a validation code is to request a code from the Provider Enrollment, Chain, and Ownership System (PECOS) that will be sent in an email.
- Submit following the entry of all required fields.
- The PEPPER will open in an EXCEL attachment. Save the attachment.
Please email the PEPPER Report to Harmony Healthcare International (HHI) for completion of your Comprehensive PEPPER Analysis.
- Facility Specific Trends
- Organizational Trends
- State Specific Trends
- National Trends
- Compliance Triggers
- Audit Triggers