QRP & VBP Validation Audits Have Begun!
As promised, CMS has begun their QRP and VBP Data Validation Program!
The first request letters were posted on January 12th!
This is a Medicare A program whose purpose is to validate the assessment based measures used for QRP and VBP.
CMS will compare MDS entries against a patient’s medical records to ensure that the MDS data used to calculate measures and payment is accurate.
As a reminder:
- Each year, CMS will randomly select 1500 facilities to review
- Up to 10 charts will be requested
- Records should be submitted electronically through a secured provided link that facilities will receive with their notification
- The SNF has 45 calendar days to submit the records or be subject to a 2% Med A penalty!
Facility selection notices will be posted in: iQIES > My Reports> MDS 3.0 Provider Preview Reports folder.
When a facility receives a selection notice they must:
- Set up primary and secondary Point of Contacts (POC) at the facility who will receive and respond to validation related communication
- Complete the POC form within 5 business days
We strongly recommend that providers check their iQIES folder as soon as possible, and then continuously thereafter, to see if they received a selection notification. There is no separate email that goes out, so you must check this folder often!!
CMS created a 14 minute YouTube video to explain the program.
This can be accessed at: https://youtu.be/B20RF412eug
CMS also created an FAQ document to answer questions: https://www.cms.gov/files/document/data-validation-process-frequently-asked-questions-12-17-2025.pdf
As always, if you have questions, or need additional information, please email us at: Medicarequestions@enhancetherapies.com
