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The Q4FY15 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2015 is now available for download through the PEPPER Resources Portal. To obtain your SNF’s PEPPER, the Chief Executive Officer, President, Administrator or Compliance Officer of your organization should:

  1. Review the Secure PEPPER Access Guide.
  2. Review the instructions and obtain the information required to authenticate access. Note: A new validation code will be required. A patient control number or medical record number from a claim for a traditional Medicare FFS beneficiary with a “from” or “through” date in September 1-30, 2015 will be required.
  3. Visit the PEPPER Resources Portal.
  4. Complete all fields.
  5. Download your PEPPER.

The SNF PEPPER will be available to download for approximately two years.

Revised in this release: The “Therapy RUGs” target area has been discontinued.

PEPPER is an educational tool that summarizes provider-specific data statistics for Medicare services that may be at risk for improper payments. Providers can use the data to support internal auditing and monitoring activities. PEPPER is distributed by TMF® Health Quality Institute under contract with the Centers for Medicare & Medicaid Services.

Contact Proactive Medial Review to:

  • Request an analysis of your facility PEPPER. The review includes a summary report and comprehensive action plan to address outliers and billing trends which may indicate overpayment risk and/or potential missed opportunities.
  • Schedule facility training on how to implement a Compliance Focused Response to SNF PEPPER.
  • Learn more about Proactive RAC preparation auditing and monitoring services through our team which includes experienced SNF/LTC therapists, AANAC certified MDS certified specialists, nursing, administrator and billing experts