tci Medicare Compliance & Reimbursement - 2019 Issue 9

Sidestep 5 High-Risk Behaviors That Heighten MIPS Scrutiny

Tip: Auto-population often leads to inaccuracy — and audit. Merit-Based Incentive Payment System (MIPS) measures that don’t meet threshold requirements followed up by lackluster supporting documentation are risky actions and may cause you to fail a MIPS audit. However, some practices skirt the rules to boost their chances of an incentive — and that’s fraud. “Overall, CMS is looking for instances of fraud, waste, and abuse of this system,” warns Lora Woltz, ONC HIT certification manager in the Eye Care Leaders April 25 webinar, “Bulletproofing the MIPS Audit File.” “If they suspect...

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