Long Term Acute Care Hospitals

IPRO, as the Quality Improvement Organization (QIO) for New York State, conducts long term acute care hospital (LTCH) medical necessity and coding/DRG validation review in accordance with Medicare 8th Scope of Work (SOW) contract deliverables for subtask 3b, the Hospital Payment Monitoring Program (HPMP).

IPRO invites LTCHs to utilize resources available to assist in the reduction of payment errors. Resources available include:

An HPMP Coding Workshop

IPRO distributed a CMS administrative data tool to each LTAC hospital to assist in identifying potential payment errors for each of the target areas. This tool, called PEPPER (for Program for Evaluating Payment Patterns Electronic Report), provides hospital-specific Medicare discharge data for fiscal years (FYs) 2003, 2004, 2005 and 2006 to date. These data provide detail on your hospital's standing in relation to other NYS LTAC hospitals, dollars received as payment for each year for target areas, length of stay data, and more.

These data were released on CD-Rom in mid-June 2006 to your hospital liaison
Download powerpoint slides to assist in interpreting your data

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.