SNF PEPPER Moving to Electronic Delivery
Author: Suzy Harvey
On January 1, 2014, TMF Health Quality Institute announced it no longer will mail skilled nursing facility (SNF) Program for Evaluating Payment Patterns Electronic Reports (PEPPER). TMF is contracted by the Centers for Medicare & Medicaid Services (CMS) to analyze and distribute PEPPERs to health care providers. SNFs first received PEPPERs via mail in August 2013. In addition to no longer mailing copies of original reports, the 2014 reports—being released in May—only will be available electronically.
SNFs and swing beds that are part of a short-term acute hospital will continue to access PEPPERs via the QualityNet secure file exchange.
TMF currently is developing a secure portal for free-standing SNFs and SNFs that are part of another type of hospital without access to QualityNet. TMF anticipates the secure portal for electronically receiving PEPPERs will be made available by the May 2014 release date. Once released, PEPPERs will remain electronically accessible for approximately one year.
TMF has issued the following requirements on the PEPPER distributions page:
- Access to the PEPPER will be restricted to the provider’s CEO, president or administrator. Corporate offices and/or facility management companies will need to obtain PEPPERs from each individual provider in their organization.
- Requestors will be required to enter their six-digit CMS certification number (also referred to as a provider number or PTAN). This is not the same as the tax identification number or national provider identification number.
- For verification purposes, requestors will be required to enter either a medical record number or a patient control number for a fee-for-service Medicare patient who received services at the provider during a specified time period (TMF will determine this time period closer to report distribution).
Note: Only numerical entries can be accepted; if providers use only letters in both of these fields, they must contact TMF to request assistance. Patient names cannot be entered due to patient privacy laws.
To receive email notification when the PEPPER is available as well as instructions on accessing PEPPERs, join the mailing list at pepperresources.com. To access the mailing list, click on the gray box in the upper-right section of the home page.
The PEPPER is a valuable tool for SNFs in identifying outliers that could put them at risk for Medicare audits. With the increased scrutiny on therapy services, minimum data set (MDS) accuracy and length of stay, the PEPPER should be a part of a proactive measure for compliance and auditing. If you are having difficulty understanding your SNF PEPPER, or have outliers and are interested in an external analysis, contact your BKD advisor.