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Federal officials recently announced a flurry of regulatory changes. Recent federal regulatory changes governing the Physician Fee Schedule (PFS), reporting on total knee arthroplasty (TKA), and coverage of the use of artificial hearts have all made headlines during recent weeks – matters that may have flown under the radar considering…
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The PEPPER now gives hospitals an opportunity to peer behind the curtain and see how they perform relative to others. In the midst of a pandemic, the Centers for Medicare & Medicaid Services (CMS) has decided the time is right to add a new element to the quarterly Program for…
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Not enough information in the public use databases to know that a claim is fraudulent. “In God we trust; all others bring data.” That is what the sign above my desk says, right next to my six-foot slide rule. I was pondering the truth behind this tongue-in-cheek saying when I…
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Clarity is badly needed for the quarterly health data report. Every quarter, the quality representatives at most hospitals receive their Program for Evaluating Payment Patterns Electronic Report (PEPPER), and every quarter the quality representatives struggle to figure out what to do with the data. And this quarter, TMF, which produces…
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The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a mystery to many. Sent to hospitals as an Excel workbook, I find it to be data-rich but information-poor.There are 56 pages of explanations, data, and tables. To make it even more frustrating, no one seems to really know who…