Hospital Payment Monitoring Program
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)
- DRG Coding Corner
- 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
Long Term Acute Care Hospitals
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.
CMS Mailing Lists: Keeping Medicare Fee-for-Service Providers Informed Through Email. The Centers for Medicare & Medicaid Services (CMS) offers a way for you to receive consistent and accurate information regarding recent news, policy changes, and updates. To subscribe to CMS Mailing lists, visit www.cms.hhs.gov/apps/mailinglists/ to see all available listservs.
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