September 05, 2018
The Centers for Medicare & Medicaid Services (CMS) posted validation criteria for the 2018 Merit-based Incentive Payment System (MIPS) program. CMS is required by statute to provide the criteria used to audit and validate measures and activities for the Quality Payment Program Year 2 for the Quality, Promoting Interoperability, and Improvement Activities Performance Categories. Because CMS calculates the Cost Performance Category through submitted claims, it is not addressed in this material.
For each of the Performance Categories, MIPS participants will need to retain documentation for up to six years, excluding the Cost Performance Category. The posted materials provides guidance on the type of documentation MIPS participants should maintain.
Under MIPS, CMS will conduct an annual data validation and audit process. If selected for a data validation or audit, you will have 45 calendar days to complete data sharing as requested or an alternate timeframe that is agreed upon by CMS and the MIPS eligible clinician or group.