Hospital Payment Monitoring Program

Centers for Medicare & Medicaid Services

The Hospital Payment Monitoring Program (HPMP), formerly known as the Payment Error Prevention Program (PEPP), was designed to work with hospitals in CMS's Prospective Payment System (PPS) to reduce inpatient services billing and payment errors. Methods used to address these errors include assessments of correct coding, DRG validation and determinations of medical necessity.

Short Term Acute Care Hospitals

Coding For Quality: Documentation and Coding Tips for Top Ten Denied DRGs (2007)
Coding For Quality: Documentation for the Top Ten Denied DRGs (2005)
IPRO's Documentation for the Top Seven DRGs
IPRO's HPMP in the News
Program for Evaluating Payment Patterns Electronic Report (PEPPER)
- CMS Target Areas for HPMP
- PEPPER Training - Earn AHIMA CEU Credit
DRG Coding Corner
- Online CE Opportunities
HPMP Compliance Workbook
Resources
Online Newsletters

Link to the Online Community Forum
Provides both upcoming and previously recorded events to assist in your Medicare Payment Error Reduction & Case Review Initiatives
Special Project: Gastro-Intestinal Disorder

Coding for Quality: Documentation and Coding Tips for Gastrointestinal Disorders

Long Term Acute Care Hospitals

Long Term Acute Care Hospitals - Resources

Recent Presentations

10/30/2007 Notification of Hospital Discharge Appeal Rights - Provider Training
10/30/2007 HPMP: Overview and Update

News

8/29/2007 - One-Day Stays and Medicare Payment Errors
8/2007 Supplemental Report: 7 Day Readmissions
5/11/2007 - Present On Admission Indicator
Effective October 1, 2007, Medicare will begin to accept a Present On Admission (POA) Indicator for every diagnosis on your inpatient acute care hospital claims. However, providers must submit the POA on hospital claims beginning with discharges on or after January 1, 2008. Critical access hospitals, Maryland waiver hospitals, long term care hospitals, cancer hospitals, and children's inpatient facilities are exempt from this requirement. For more information, visit http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5499.pdf.

For more information about the Hospital Payment Monitoring Program, please contact Andrea Goldstein, Vice President, Medicare/Federal Healthcare Assessment at (516) 326-7767 ext. 364.

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