QPP Audits Now Underway, According to CMS
The Centers for Medicare and Medicaid Services (CMS) announced last month that the Merit-based Incentive Payment System (MIPS) Data Validation and Audits have begun. Though there is little information currently available regarding the audit process, CMS has provided some details to aid participants in their preparations.
The validation and audit will include both 2017 and 2018 performance periods, respectively, and will be carried out by Guidehouse, a consulting firm contracted by CMS. Requests to provide information to Guidehouse will be received by certified mail.
If selected for audit, you will be asked to provide results of reporting (typically screenshots or software generated report(s)) for the reporting year in question within 45 days from the date of the notice. All measures submitted, during attestation, in the Quality, Advancing Care Information (currently referred to as Promoting Interoperability), and Improvement Activity categories will require supporting evidence to substantiate compliance. As 2017 was the first Quality Payment Program (QPP) reporting year and a test of the QPP was offered, you could be required to submit significantly less information for this performance year.
You may review the individual measures and measure categories being reviewed by CMS on the Quality Payment Program Resource Library.
- 2017 MIPS Data Validation Criteria – Lists the 2017 criteria used to audit and validate data submitted in each performance category
- 2018 MIPS Data Validation Criteria – Lists the 2018 criteria used to audit and validate data submitted in each performance category
ChiroTouch will continue to provide updates on the audit process as they become available. If you have questions contact CMS directly at QPP@cms.hhs.gov or 1-866-288-8292 (TTY 1-877-715- 6222), Monday through Friday, 8 AM -8 PM EST.