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Health Care Chair Paula Sanders and Associate Laura Weeden Provide Guidance on PEPPERs Compliance for SNFs in the HCCA's March 2014 Compliance Today

In the March 2014 issue of the Health Care Compliance Association's (HCCA) Compliance Today, Health Care Practice Group Chair Paula G. Sanders and Associate Laura M. Weeden offer guidance on how skilled nursing facilities (SNF) can best comply with their facilities' Program for Evaluating Payment Patterns Electronic Reports (PEPPERs). 

They note in the article that PEPPERs, "help position and prepare...organizations for Medicare audits targeted at potential improper billings related to therapy services." However, "other healthcare providers have been receiving PEPPERs for a number of years, but Medicare certified skilled nursing facilities (SNFs) only started getting PEPPERs in late 2013. Many SNFs have not yet developed robust strategies for reviewing their PEPPERs and thus may not appreciate the value that their compliance team can bring to their PEPPER analyses."

Ms. Sanders and Ms. Weeden address some of the following points throughout the article: 

  • PEPPER is a roadmap for assessing areas at risk of improper Medicare billing.
  • Use PEPPER to support the auditing and monitoring component of compliance.
  • Scrutinize risk areas and incorporate them into regular compliance assessments.
  • Failure to review PEPPER findings may be seen as reckless disregard.
  • SNF PEPPERs will be available electronically between May 5 and May 12, 2014