CMS has officially launched a new initiative to validate MDS assessment accuracy—and the stakes are high. Under the SNF PPS Fiscal Years 2024 and 2025 final rule, 1,500 SNFs will be randomly selected each year for intensive data audits. Non-compliance could result in a 2% reduction in your Annual Payment Update (APU).

Coretactics is currently helping facilities navigate these new requirements, ensuring their MDS data is accurate and their monitoring systems are airtight.

What is Different?

These audits aren’t like the ones we’ve seen before. They focus specifically on MDS-based quality measures used in VBP and QRP programs and are managed by a third-party contractor (Healthcare Management Solutions, LLC).

“Hidden” Notification Process

Perhaps the most critical change is how you are notified. CMS will not send an email. Notifications are posted exclusively in the iQIES system under the MDS 3.0 Provider Preview Reports folder. Once that notice is posted, the clock starts, and you have:

• 5 Business Days to submit your primary and secondary Points of Contact.
• 45 Calendar Days to submit all required medical records.

Be Prepared

With the 5-day window, your team must be monitoring iQIES at least once per week. If you haven’t checked your iQIES folder this week, now is the time. Ask yourself:

• Do you know what to look for?
• Do you know how to find it?
• Do you have a designated person to monitor iQIES?
• Do you know what the letter looks like?

We know these answers. Let’s connect! We can help you prepare your SNF for these changes.

Our SNF Audit Readiness Checklist

We’ve distilled the new CMS requirements into a simple, one-page checklist to ensure your team never misses a notification or a deadline. Use this to assign roles and secure your 2% payment update. When you receive your letter, reach out to us. Our experts will focus on securing your 2% payment update and the submission of requested documentation within the 45-day window. 

 Download Coretactics Audit Readiness Checklist

Resources: CMS SNF Data Validation Process Page