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Puerto Rico Hospitals

Section 602 of the Consolidated Appropriations Act of 2016 amended section 1886(n)(6)(B) of the ACT to include subsection (d) hospitals in Puerto Rico in the definition of "eligible hospital" which made subsection (d) Puerto Rico hospitals eligible for the Promoting Interoperability Program incentive payments for hospitals that are meaningful users and subject to payment reductions for hospitals that are not meaningful users.

EHR Reporting Period

For fiscal year (FY) 2018, 2019, and 2020 payment years, the EHR reporting period is a minimum of any continuous 90-day period in calendar year’s 2018, 2019, and 2020 respectively for Puerto Rico eligible hospitals. 

EHR Reporting Period for a Payment Adjustment Year

Payment reductions will apply beginning with FY 2022 for subsection (d) Puerto Rico hospitals that are not meaningful EHR users for the applicable EHR reporting period for the payment adjustment year.

Because Puerto Rico eligible hospitals are considered eligible hospitals, the EHR reporting periods for payment adjustment years and related policies, including deadlines and requests for significant hardship exceptions, that we establish for eligible hospitals would also apply to Puerto Rico eligible hospitals beginning with the FY 2022 payment adjustment year.

Duration and Timing of Incentive Payments

Below lists the timing of incentive payments for which Puerto Rico eligible hospitals may receive incentive payments:

  • First payment year: FY 2016
    • Payments received: FYs 2016-2019
  • First payment year: FY 2017
    • Payments received: FYs 2017-2020
  • First payment year: FY 2018
    • Payments received: FYs 2018-2021

Reporting Requirements for Medicare Hospitals and CAHs

In 2019, eligible hospitals, CAHs, and dual-eligible hospitals attesting to CMS will be required to report on four objectives. The 2019 Medicare specification sheets can be found here.