Navigating Targeted Probe And Educate - Using PEPPER


[W3235] Navigating Targeted Probe And Educate - Using PEPPER
Details of these programs and what steps take to navigate and utilize them.

TAHC&H WEBINAR: This webinar was presented on 10/03/2018. Subscribers receive 24/7 on-demand access from both home and office during the subscription period shown at the bottom of this page.

Presentation Info:

  • Presentation Date: October 3, 2018
  • TAHC&H Event: TAHC&H Monthly Webinars

Education-Training Credits:

  • TX HCSSA Administrator/Alternate Continuing Education
    • 1.0 Clock Hrs

CE Approval Statements:
· This program meets continuing education requirements for Administrators and Alternates under Texas HCSSA licensing regulations.

HCSSA Topic(s) Addressed:

  • §558.259[d][4]agency responsibilities
  • §558.260[a][6]risk assessment and management

Program Description: CMS believes results of the Home Health Probe and Educate program have been favorable based on the decrease in claim errors after providers received education. It is now moving from a broad Probe and Educate program to a more targeted one. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a comparative data report that summarizes a single provider’s Medicare claims data statistics in areas identified as at risk for improper Medicare payments, such as poor clinical and Medicare coverage documentation. To develop the HHA PEPPER, Medicare claims data for all HHAs in the nation were analyzed to identify “target areas” which could be at risk for improper Medicare payment. In this webinar, Anthony Cutrona and Heidi Kocher will discuss details of these programs and what steps take to navigate and utilize them.

Program Learning Outcome:

  • Participants will actively engage in the learning activity and indicate an intent to change their practice by using the PEPPER reports to target documentation enhancements that will result in more successful Targeted Probe and Educate results. 

TAHC&H Faculty/Presenters: Anthony Cutrona and Heidi Kocher | Liles Parker Attorneys & Counselors at Law

About the Presenter:
Anthony Cutrona
began practicing home health law as general counsel for a Houston home health agency in 1996 and opened his solo health law practice in 1997. In 2000, the Texas Association for Home Care named him its Associate Member of the Year. Last year, after 20 years of representing home health care providers throughout Texas, Anthony joined Liles Parker as a Partner and opened its San Antonio office. He continues to represent home health agencies in license and survey matters, administrative appeals, implementation of compliance programs, employment issues, and defends nurses in Board of Nursing matters.

About the Presenter:
Heidi Kocher
is a partner with Liles Parker and has over 20 years of experience in health care legal and compliance related issues, including serving as a compliance director, chief privacy officer and interim chief compliance officer at a medical device manufacturer. In addition, she has represented and advised physician groups, home health agencies, DME companies, pharmacies, non-profit organizations, and licensed individuals. Her experience includes implementing the various requirements and aspects of a Corporate Integrity Agreement, responding to and defending audits from Medicare, Medicaid and private insurers up through the ALJ level, guiding clients through voluntary self-disclosures and seeking advisory opinions from the OIG. She also has significant reimbursement experience, addressing coverage policy issues, challenging denials, recoupments, and loss of billing privileges, obtaining HCPCS codes, and other reimbursement related issues.

[W3235] Navigating Targeted Probe And Educate - Using PEPPER

Subscribers to this webinar receive 24/7 on-demand access for one (1) month. When subscribing to this webinar along with other programs totaling 12 hours or more, the access period increases to six (6) months.

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