We are writing to make you aware of an important matter concerning MIPS Data Validation Audits (DVA). The Centers for Medicare & Medicaid Services (CMS) has engaged an external company, Guidehouse, to conduct MIPS DVA audits for Performance Year (PY) 2023.
DVA audits will take place from October 2024 until April 2025. If your practice is selected for audit, you will receive an email from mips_dva_request@guidehouse.com.
Action Recommended
To prepare for a potential audit, we recommend the following actions:
- Add mips_dva_request@guidehouse.com to your email contacts and periodically check your spam or junk folders.
- Verify that the contact information for your practice’s security official is up to date in the HARP System as this is the email address Guidehouse will use.
- Review the Merit-based Incentive Payment System (MIPS) Data Validation and Audit (DVA) Fact Sheet to ensure you are familiar with this process.
What Do I Do If I Am Audited?
The initial email from Guidehouse will include the following details:
- A request list including the measure(s) being audited with a breakdown of timelines, deadlines, and phases of the audit.
- Instructions for uploading your audit response.
- An Excel spreadsheet for you to add the requested patient/measure information.
- If the eCQM measure being audited was submitted using gGastro®, users may access this information from gGastro’s MIPS report.
- If you require assistance, please contact our Support Team at gsupport@modmed.com.
Submit the requested information by the deadline specified in the email from Guidehouse. Failure to respond to an audit request may result in penalties, fines, and/or recoupment of incentive money received.
Reminder: EUC Exception Deadlines
In addition to notifying you of MIPS DVA audits, we would like to take this opportunity to remind you that the Change Healthcare EUC Exception deadline is approaching. The 2024 application will remain open until 8:00 PM Eastern Time (ET) on Tuesday, December 31, 2024. For additional information concerning the EUC Exception, please refer to the Extreme and Uncontrollable Circumstances Exception Application Guide.
MIPS Advisory Services
With ModMed’s MIPS Advisory Services, a dedicated advisor can help you meet your goals! MIPS Advisors, who are trained in gGastro, can work with you to build your practice’s custom MIPS project plan and answer questions, monitor your performance, and more. Fill out the form here to get in touch with the MIPS team.
Please send DVA questions to MIPS_DVA@Guidehouse.com. For questions about the QPP, contact CMS at QPP@cms.hhs.gov.