CMS Begins First-Ever MIPS Audits, Covers 2017 and 2018 Reporting

The Centers for Medicare & Medicaid Services says it will audit Merit-Based Incentive Payment System participants beginning this month. These audits will affect a sample of 2017 and 2018 MIPS-eligible clinicians. The Academy has expert resources you need to navigate this process. 

Contact mips@aao.org if you receive a notice for a MIPS audit so that the Academy can assist you and improve our member resources. 

If you are selected for data validation or audit:

• You will receive a request for information from Guidehouse, the CMS-contracted auditor for this review, by email or certified mail (be sure to check your spam folders).

• You are required to comply with the audit and must provide all data requested.
• You will have 45 calendar days from the date of the notice to provide the information.
• If you reported MIPS through IRIS^® Registry-EHR integration and are audited, email irisregistry@aao.org so that the Academy can provide you with a letter documenting your participation in the registry. 

For each of the performance categories, you will need to keep documentation for up to six years, excluding the cost category.

• Quality: MIPS-eligible clinicians, groups and virtual groups should retain supporting documentation for the data submitted to the IRIS Registry or another qualified clinical data registry.
• Promoting Interoperability: Keep documentation to support your submissions. More.
• Improvement Activities: The documentation used to validate your activities should demonstrate consistent and meaningful engagement within the period for which you attested. More.
• Cost: No data documentation will be needed from physicians, since clinicians do not submit cost measures. Rather, measures are calculated by CMS based on Medicare claims.