June 25, 2019
The Centers for Medicare and Medicaid Services (CMS) will conduct data validation and audits of a select number of Merit-based Incentive Payment System (MIPS) eligible clinicians for performance years 2017 and 2018. Data validation and audits help ensure that MIPS is operating with accurate and useful data. MIPS eligible clinicians, groups and virtual groups are required by regulation to comply with data sharing requests and provide all data as requested by CMS.
Participants that are selected for data validation and/or audit will receive a request for information that is sent via email or by certified mail. The requested information must be provided 45 calendar days from the date of notice. If the requested information is not provided, CMS may take further action, including the possibility of selection for future audits.
The following data validation and audit resources are available on the Quality Payment Program Resource Library:
Lists the 2017 criteria used to audit and validate data submitted in each performance category.
Lists the 2018 criteria used to audit and validate data submitted in each performance category.