Preparing for a MIPS Audit

The Centers for Medicare & Medicaid Services (CMS) has engaged an external company, Guidehouse, to conduct MIPS data validation audits (DVA) for the 2023 performance year. 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.

Here's what you can do to prepare for a potential audit:

• 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 CMS's Merit-based Incentive Payment System (MIPS) Data Validation and Audit (DVA) Fact Sheet  to ensure you are familiar with this process.

Responding to an Audit Notice

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 measure information.

If you used Eyefinity EHR for your submission, follow the instructions in these related topics to generate the requested data:

• Reviewing Quality
• Reviewing Promoting Interoperability Measures

If you used ExamWRITER for your submission, follow the instructions in these related topics to generate the requested data:

• Tracking and Reporting Quality Performance with ExamWRITER
• Tracking and Reporting Promoting Interoperability Performance with ExamWRITER

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 a recoupment of incentive money received.