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Quality Payment Program (QPP) Support Center

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MIPS Audits for Performance Years 2017 and 2018 Are Beginning


The Centers for Medicare & Medicaid Services (CMS) has contracted with Guidehouse to conduct data validation and audits of a select number of MIPS eligible clinicians. Data validation and audits are processes that will help ensure 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, providing all data as requested by CMS.
If you are selected for data validation and/or audit, you will receive a request for information from Guidehouse. It will be sent via e-mail or by certified mail. Please be on the lookout for this notification. You will have 45 calendar days from the date of the notice to provide the requested information.
Please note, if you do not provide the requested information, CMS may take further action, including the possibility that you will be selected for future audits. To help avoid this, CMS is in the process of developing resources to support clinicians selected to participate.
The following data validation and audit resources are available in the QPP Library: Subscribe to the QPP listserv by entering your e-mail at the bottom of the QPP website so that you receive notifications about the most up-to-date MIPS data validation and audit information available.