decisionhealth Newsletters, Part B News - 2019 Issue 10 (October)
As MIPS audits get rolling, protect yourself with proof files of your submissions
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Article Overview
This article explains how clinicians and practice staff can prepare for CMS data validation audits related to Merit-based Incentive Payment System reporting. It focuses on the types of supporting documentation CMS may want to see, how different MIPS reporting methods affect audit risk, and what kinds of records practices should preserve for attestation-based measures and improvement activities. The piece is aimed at practices, compliance staff, and reporting vendors that manage MIPS submissions and audit readiness.
Why This Topic Matters
MIPS participants may be asked to substantiate reported data after submission, so having organized proof files can help practices respond to audit requests and reduce the risk of missing documentation. The article is relevant to organizations that report quality, promoting interoperability, and improvement activity measures.
Article Sections
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Overview of MIPS audit risk
Introduces the reporting context for MIPS and explains why some submissions may later be reviewed for supporting evidence.
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Use the guides
Discusses CMS data validation guidance and the general kinds of documentation practices may be expected to keep for audit readiness.
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5 more tips for the proof files
Summarizes practical recordkeeping considerations for maintaining supporting files, coordinating with vendors, and preserving documentation over time.
What You Will Learn
- How MIPS reporting methods relate to audit readiness
- What categories of documentation are discussed for validation purposes
- Why maintaining supporting files matters for attestation-based reporting
- How vendors and registries may fit into documentation preparation
- What broad record-retention and file-management considerations are highlighted
Who Should Read This
- Physician practices
- Compliance staff
- Quality reporting staff
- Practice managers
- MIPS reporting vendors
- Registry and QCDR users
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