TMF will distribute PEPPER according to the schedule and methods below. 

Note: Due to data restrictions established by CMS, provider data are not displayed in a time period in PEPPER in any given target area if the numerator or denominator is less than 11. This data restriction may result in a small number of providers either not receiving a PEPPER (numerator count less than 11 in all time periods, all target areas) or their PEPPER may not display data in some time periods for some target areas.

Note: IPF and IRF PEPPERs are not available for Maryland distinct part units of short-term acute care hospitals.

Providers Accessing PEPPER via PEPPER Resources Portal

Watch this video demonstrating how to access a PEPPER through the PEPPER Resources secure portal for those providers that do not have access to QualityNet accounts. Refer to the Secure PEPPER Access Guide (PDF) for step-by-step instructions on how to download your PEPPER.

The following providers will receive PEPPER via the PEPPER Resources Portal :

• Long-term acute care hospitals
• Hospices
• Free-standing Inpatient rehabilitation facilities
• Free-standing partial hospitalization programs (PHPs) and PHPs administered by providers other than short-term acute care hospitals or IPFs
• Free-standing skilled nursing facilities (SNFs)
• Home health agencies (HHAs)

The PEPPERs are available through the PEPPER Resources Portal. They will remain accessible for approximately two years from the original release date. Providers do not need to register to obtain the report. Join the email list to receive information regarding future PEPPER releases and training opportunities.

Please note these requirements to access PEPPER via the PEPPER Resources Portal:

1. Access to the PEPPER is restricted to the provider’s chief executive officer, president, administrator or compliance officer. Corporate offices and/or facility management companies will need to obtain PEPPERs from each individual provider in their organization.
   Note: if a provider does not have anyone with any of these titles, the person who has the authority to make decisions on behalf of the organization should check the box for the title that best describes their position.
   
   TMF has received a number of questions regarding who can access a provider’s PEPPER via the PEPPER Resources portal. TMF designed the portal to meet CMS security standards and to comply with guidance from TMF’s legal counsel. A provider’s PEPPER is considered sensitive data. We recognize that restricting access to a provider’s PEPPER to the Chief Executive Officer, president, administrator or compliance officer (the individual who has the authority to make decisions on behalf of the organization) may disappoint some provider staff who seek to obtain their provider’s PEPPER. Please keep in mind that previously PEPPERs were sent in hard-copy format to the attention of the chief executive officer, administrator or compliance officer. PEPPERs distributed via QualityNet are available to those with QualityNet accounts; these individuals must go through a rigorous application process in order to obtain access to QualityNet. We apologize for any inconvenience these security restrictions present, however TMF is committed to ensuring and maintaining the confidentiality of each provider’s PEPPER and asks for your understanding and cooperation.
2. Requestors will be required to enter their 6-digit CMS certification number (also referred to as provider number or PTAN). This is *not* the same number as the tax identification number or national provider identification number.
3. For verification purposes, requestors will be required to enter either a patient control number (found at form locator 03a on the UB04 claim form) *or* a medical record number (found at form locator 03b on the UB04 claim form) for a traditional fee-for-service Medicare Part A patient who received services at the provider during this specified time period:

• For the version Q4CY17 PEPPER released in July 2018 for HHAs and PHPs, October - December 2017 (either the “From” or “Through” date on the paid claim is between October 1 - December 31, 2017)
• For the version Q4FY17 PEPPER released in April 2018 for SNFs, Hospices, IRFs, and LTs: July - September 2017 (either the “From” or “Through” date on the paid claim is between July 1 - September 30, 2017)
Note: Do not enter any commas, decimals, dashes or spaces. Patient names cannot be entered due to patient privacy laws.

Special Note for HHAs: Some HHAs have identified that the patient control number (PCN) that they obtained from the UB04 claim form for a traditional, Medicare fee-for-service beneficiary was very different from the claim number TMF obtained from the paid claims database. TMF has researched this issue in coordination with CMS and Medicare Administrative Contractor (MAC) staff and has reached out to HHAs that did not have trouble accessing their PEPPER. TMF learned that:


1. The MAC does not change the PCN; they process the claim as it was received from the HHA or from the vendor authorized to transmit claims on behalf of the provider.
2. Some billing software/vendors use the beneficiary health insurance claim number (HICN, or Medicare number) as the patient control number. TMF determined that only 0.25% of the eligible patient control numbers to access PEPPER are formatted as a HICN.

Therefore, we suggest that HHAs not use a PCN that is the same as the beneficiary HIC number to access their PEPPER. Instead, we recommend they use the remittance advice (RA) received from the MAC to obtain a patient control number. Select a PCN for a claim with a “from” or “through” date between October 1 - December 31, 2017.

Providers Accessing PEPPER via QualityNet Portal

PEPPERs are uploaded to the QualityNet accounts of QualityNet Administrators and those who have QualityNet basic user accounts with the PEPPER Recipient roles. Having trouble downloading your PEPPER from QualityNet? View instructions for downloading your PEPPER.

The following providers will receive PEPPER via QualityNet Portal:

• Short-term acute care hospitals
• Critical access hospitals
• Inpatient rehabilitation facilities (IRFs) that are distinct part units of acute care hospitals
• Inpatient psychiatric facilities (IPFs)
• Partial hospitalization programs (PHPs) administered through short-term acute care hospitals or an IPF
• Skilled nursing facilities (SNFs) that are part of acute care hospitals (whose Medicare provider/billing number is a 6-digit/character number, with the third character of “U”)

PEPPER files are uploaded to the Secure File Transfer AutoRoute inbox of hospital QualityNet Administrators and those who have basic user accounts with the PEPPER recipient and File Exchange and Search roles. If you are one of the provider types noted above and you are either a QualityNet Administrator or have a basic user account with the PEPPER recipient and File Exchange and Search roles, please visit the QualityNet Portal to obtain your facility's report and forward it internally as appropriate. Please note: the QualityNet account must be an active registered account at the time the files are distributed in order to receive the PEPPERs.