Accessing Hospice PEPPER Reports Can Help Avoid Audits

Hospices who understand and consider their Program for Evaluating Payment Patterns Electronic Reports (PEPPER) from their Medicare Administrative Contractor (MAC) can leverage that information to anticipate and correct payment issues that could lead to targeted probe and education (TPE) audits if left unaddressed.  PEPPER contains provider-specific Medicare claims data that may indicate or create the […]

Rising Costs Put Hospice in Regulatory Crosshairs

In the midst of rising demand, costs, and sharpened regulatory scrutiny, many hospice providers are facing Medicare recertification review challenges that can seriously harm patients and families, as well as their own bottom lines. The U.S. Centers for Medicare & Medicaid Services (CMS) requires hospices to recertify patients who have survived beyond their initial estimated […]

Half of Hospices Unprepared for Regulatory Audit

Fewer than 50% of hospices indicated that they were ready for a federal audit or additional document request, according to a recent survey by Optima Health. As hospices come under increasing regulatory scrutiny, ensuring complete and accurate documentation is a growing concern. “The quality of a hospice provider’s documentation can determine the outcome of a […]