The MIPS DVA for Performance Year (PY) 2022 will begin November 2023.

October 30, 2023- The Centers for Medicare & Medicaid Services (CMS) has contracted with Guidehouse to conduct data validation and audits (DVAs) of MIPS eligible clinicians or groups in accordance with the legislative authority set forth in 42 CFR 414.1390(a)-(d). This regulation requires MIPS eligible clinicians or groups to comply with data sharing requests, providing all data as requested by CMS. Data validation and audits are designed and conducted to confirm the accuracy and completeness of reported results of the MIPS program.

If you are selected for the MIPS DVA, an email will be sent to the Security Official in your Health Care Quality Information Systems Access, Roles, and Profile (HARP) account. Please review that the contact information is up to date in the HARP system. The email will be sent from Guidehouse (MIPS_DVA_Request@guidehouse.com).

MIPS participants selected for DVA can expect notification of selection and initial requests for information starting November 2023 through March 2024. There may also be ad hoc DVA work that is conducted through 2024. You will have 45 days from the date of the notice to provide the requested information of substantive, primary source documents. These documents may include: copies of claims, medical records for applicable patients, or other resources used in the data calculations for MIPS measures, objectives, and activities. Primary source documentation also may include verification of records for Medicare and non-Medicare patients where applicable.

Please note, failure to provide the requested information for the DVA could result in a payment adjustment in accordance with the legislative authority set forth in §§ 405.980 through 405.986. It may also increase the possibility that you will be selected for future DVA. If a third-party is used for MIPS data submission, MIPS participants are accountable to ensure that all requested audit documentation is provided in a complete and timely manner.

Please refer to the Merit-based Incentive Payment System (MIPS) Data Validation and Audit (DVA) Factsheet for PY 2022 for additional information at MIPS DVA Fact Sheet PY 2022 (PDF, 226KB). If you have questions pertaining to the DVA, please contact Guidehouse at MIPS_DVA@guidehouse.com.

Or you may contact the Quality Payment Program Service Center at 1-866-288-8292, Monday through Friday, 8 a.m. – 8 p.m. ET or by e-mail at: QPP@cms.hhs.gov. Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

Do not send Protected Health Information (PHI)/Personally Identifiable Information (PII) to MIPS_DVA@guidehouse.com or send emails to MIPS_DVA_Request@guidehouse.com as this is an out-going only email box that is not monitored.