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- CMS Plans to Audit Some Practices That Report MIPS
The Centers for Medicare & Medicaid Services (CMS) announced that it plans to act within its regulatory authority to randomly audit MIPS-eligible clinicians and groups on a yearly basis. Suppose a MIPS-eligible clinician or group is selected for audit. In that case, the MIPS-eligible clinician or group will have 45 days from the date of the notice to provide the requested information of substantive, primary source documents. It is unclear whether pathology practices will be included in these audits. MIPS participants selected for audit will be notified starting in January 2023.
Under MIPS, pathologists are included if they are an eligible clinician type and meet the low volume threshold, which is based on allowed charges for covered professional services under the Medicare Physician Fee Schedule (PFS) and the number of Medicare Part B patients who are furnished covered professional services under the Medicare Physician Fee Schedule.
If you have questions about MIPS, contact mips@cap.org.