TMF Health Quality Institute

Under the Merit-based Incentive Payment System (MIPS), the Centers for Medicare & Medicaid Services (CMS) will conduct an annual data validation process. Clinicians will be randomly selected for the audit. While it is unknown how many clinicians will receive a request, historical programs audited approximately one in 10 clinicians.

CMS makes available the criteria used to audit and validate measures and activities for the Quality, Promoting Interoperability and Improvement Activities categories of MIPS.

Helpful hints for audit readiness:

  1. Maintain readiness by performing a mock audit.
  2. As you prepare for MIPS submission, prepare for an audit as well by keeping all required documentation in a secure location.
  3. When saving documentation, it is recommended to save in at least two different formats (e.g., paper format in a binder, electronically saved to a local desktop computer or server, a flash drive or the TMF MIPS Toolbox).
  4. Be sure to organize documents by program year and by group or individual clinician, based on reporting method.

  Read the article for more information about how to be prepared in case of an audit.