New PEPPER data dives deeper into functional status

Effective Jul 18, 2022

Published Jul 18, 2022

Last Reviewed Jul 18, 2022

The latest release of the Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) has added a more focused review of functional status.

CMS released fourth quarter calendar year 2021 PEPPER reports for home health agencies on July 8.

These reports summarize provider-specific data for Medicare services that may be at risk for improper payments. Use the data to support internal auditing and monitoring activities.

New in the latest release: The percentage of periods with a functional impairment level of medium and the percentage with a functional level of high.

Outliers would be those agencies with a score at or above the 80^th percentile, according to the HHA PEPPER User’s Guide

“This could indicate over-representation of the functional impairment status on the OASIS,” the guide states. “A review of OASIS responses of functional impairment may be warranted to confirm the accuracy of the responses.”

See PEPPER data: https://pepper.cbrpepper.org/Data/Home-Health-Agencies.
See the user’s guide: https://bit.ly/3ySgFw5.

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