tci Part B Insider - 2019 Issue 6

Compliance: Know the Facts on MIPS Audits

Hint: Keep detailed notes and dates for back-up. Part B providers have a lot on their plates already with ramped-up claims scrutiny from Medicare carriers, RACs, CERT auditors, and more. In addition, CMS policy rollbacks, turnaround, and upsets appear to be becoming the norm instead of the exception. And now Merit-Based Incentive Payment System (MIPS) submissions are under the audit microscope — and experts warn it’s not a matter of if, but when. 2019 status reminder: Remember, the 2019 Quality Payment Program (QPP) participation standards were scaled back for Performance Year 3. Now, MIPS-eligible clinicians (ECs) must meet...

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