Administrative Memos

200802

FROM: Theodore O. Will, Chief Executive Officer
DATE: May 29, 2008
SUBJECT: Important Update Regarding the Hospital Payment Monitoring Program (HPMP)
IPRO CONTACTS:

Kathy Terry, Ph.D., Sr. Director, Data Analysis & Evaluation, Medicare/Federal Health Care Assessment at 516-209-5562

Important Update Regarding the Hospital Payment Monitoring Program (HPMP)

The purpose of this memorandum is to advise you that effective August 1, 2008, with the beginning of the 9th Statement of Work, Quality Improvement Organizations (QIOs) will no longer be responsible for implementing the Hospital Payment Monitoring Program (HPMP). Funding for QIO assistance related to these responsibilities will cease.

The purpose of HPMP was to measure, monitor, and reduce the incidence of improper fee-for-service inpatient acute care Medicare payments. These responsibilities are being transferred to other entities (e.g., the national, inpatient fee-for-service Medicare error rate will be sampled under the Comprehensive Error Rate Testing (CERT) program beginning in April 2008. More information on the CERT program is located at http://www.cms.hhs.gov/cert ). Therefore, as of August 1, 2008 the support and education provided by IPRO related to payment error reduction will no longer be available.

As you are aware, as a current statewide HPMP initiative, IPRO, as well as many other QIOs, distribute quarterly hospital-specific comparative data reports (the Program for Evaluating Payment Patterns Electronic Report, or PEPPER) prepared by the HPMP QIO Support Contractor (QIOSC). At this time the Centers for Medicare and Medicaid Services (CMS) has not determined whether these reports will be generated after January 2009. CMS has also advised that the tools and resources, including PEPPER Users Guide, posted at http://www.hpmpresources.org will be available through January 2009. Although not required to do so, IPRO does plan to continue to distribute the PEPPERs through the January 2009 data release.

In regard to the most recent release of PEPPER, please note that a metric for readmissions within 30 days has recently been added. Information about this revised target area is included in the Users Guide as well as in IPRO's May - June 2008 issue of UR Alert (which may be found at http://projects.ipro.org/index/hpmp-ur-alert08 .

Should you have additional questions or concerns regarding this memorandum, or the data discussed, please contact Dr. Kathy Terry at 516-209-5562.