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Hospital Payment Monitoring Program (HPMP)

 

Effective Aug. 1, 2008, with the beginning of their 9th Scope of Work, Quality Improvement Organizations (QIOs) were no longer responsible for conducting the Hospital Payment Monitoring Program (HPMP).

The purpose of HPMP was to measure, monitor and reduce the incidence of improper fee-for-service inpatient acute care Medicare payments. QIOs are no longer responsible for these functions and funding for QIO assistance related to these responsibilities has ceased. Hospitals should be aware that support and education provided by QIOs related to payment error reduction is no longer available. Hospitals may wish to contact the following organizations for questions previously directed to QIOs related to compliance or payment error reduction activities:

Under the HPMP, many QIOs distributed quarterly hospital-specific comparative data reports (the Program for Evaluating Payment Patterns Electronic Report, or PEPPER) to hospitals within their respective states. The PEPPERs are now, beginning January 2010, produced and distributed to hospitals by TMF Health Quality Institute under contract with CMS.  For up-to-date information about the PEPPERs, visit PEPPERresources.org, the official site for information, training and support related to the reports. 

QIOs will continue to perform other statutory and regulatory mandated review activities and quality improvement as described in the 9th Scope of Work.
Inpatient records for calculating the national 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.

Information about the special projects conducted by AFMC under the Hospital Payment Monitoring Program (HPMP) and the Payment Error Prevention Program (PEPP) can be found by clicking on the individual projects listed on the right side of this page.