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Eligible Hospital Information

CMS is renaming the EHR Incentive Programs to the Promoting Interoperability (PI) Programs to continue the agency’s focus on improving patients’ access to health information and reducing the time and cost required of providers to comply with the programs’ requirements. CMS is also in the process of finalizing updates to the programs through rulemaking. For more information, visit the landing page where CMS will publish updates and additional resources as soon as they are available.

CMS is continuing efforts to reduce burden by easing reporting requirements and streamlining data submission methods for eligible hospitals and CAHs attesting to CMS for the  PI Programs (formerly named the EHR Incentive Programs).

For the 2018 reporting period:

  • Medicare eligible hospitals and CAHs will use the QNet system to submit meaningful use attestations.
  • The Registration and Attestation System will continue to be available for Medicaid-only hospitals and CAHs. These hospitals should contact their state Medicaid agencies for specific information on how to attest.
  • Eligible hospitals and CAHs attesting to CMS for both the Medicare and Medicaid PI Programs as dually eligible hospitals or CAHs will register and attest for the Medicare program in the QNet system.
  • Dually eligible hospitals new to the PI Programs must register in the Registration and Attestation system and register in QNet.

The goal of this change is to make it more simple for facilities to report data to CMS. Instead of reporting CQMs and meaningful use attestations in two separate systems, eligible hospitals and CAHs will be able to report this information through one portal.

Hospitals will not need to do anything differently to prepare for this transition. Instead, they can continue to collect data the way they normally would.

For information on QNet account registration, please review the QNet User Guide. The User Guide includes step-by-step instructions for creating an account on QNet.

Medicare Eligible Hospitals and CAHs

The following hospitals are eligible to participate in the Medicare PI Program:

  • "Subsection (d) hospitals" in the 50 states or DC that are paid under the Inpatient Prospective Payment System (IPPS)
  • CAHs
  • Medicare Advantage (MA-Affiliated) Hospitals

Medicaid Eligible Hospitals and CAHs

The following hospitals are eligible to participate in the Medicaid PI Program:

  • Acute care hospitals (including CAHs and cancer hospitals) with at least a 10 percent Medicaid patient volume
  • Children's hospitals (no Medicaid patient volume requirements)

 Dually Eligible Hospitals and CAHs

Eligible hospitals and CAHs that are eligible to participate in both the Medicare and Medicaid PI Programs as dually eligible hospitals and CAHs:

  • May be subject to the Medicare payment reduction for failing to demonstrate meaningful use.
  • May be eligible to earn a Medicaid incentive payment for demonstrating meaningful use successfully.

Dually eligible hospitals that successfully attest to CMS will avoid a Medicare payment adjustment and satisfy the Medicaid PI Program requirements.

 Medicare and Medicaid Eligible Hospital and CAHs PI Program

In meeting the PI Programs’ requirements for 2015 through 2017 (Modified Stage 2) and Stage 3, eligible hospitals and CAHs will focus on advanced use of certified EHR technology (CEHRT) to support health information exchange and interoperability, advanced quality measurement, and maximizing clinical effectiveness and efficiencies.

Objectives and Measures

  • All eligible hospitals and CAHs are required to report to a single set of:
  • Hospitals have the option of reporting to Stage 3 in 2017. In 2018, all new and returning participants attesting to CMS or their State Medicaid agency have the option to attest to the Modified Stage 2 objectives and measures.

Clinical Quality Measures

  • Eligible hospitals and CAHs must report to 16 clinical quality measures (CQMs). Visit the eCQM Library page for more information. 

Reporting Period

  • The PI reporting period is a minimum of any continuous 90 days between January 1 and December 31, 2018. 

Payment Information

  • The last year for Medicare eligible hospitals and CAHs to earn an incentive payment was 2016, except hospitals in Puerto Rico.
  • Medicaid incentive payments continue through 2021.
  • Eligible hospitals and CAHs that do not successfully demonstrate meaningful use of CEHRT are subject to Medicare payment adjustments.
  • There are no payment adjustments under the Medicaid PI Program.

Resources

EHR Hospital Presentations

 

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