Learn More About Medicare Promoting Interoperability Program Requirements and New Resources for 2021
In the Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals and the Long-term Care Hospital (LTCH) Prospective Payment System Final Rule, the Centers for Medicare & Medicaid Service (CMS) finalized changes and requirements for the Medicare Promoting Interoperability Program for eligible hospitals, critical access hospitals (CAHs), and dual-eligible hospitals attesting to CMS.
Below are requirements and new resources available for Medicare Promoting Interoperability Program participants for the 2021 reporting period.
Changes for 2021 include:
- Maintaining the Electronic Prescribing objective’s Query of Prescription Drug Monitoring Program measure as optional and worth five bonus points.
- Modifying the name of the Support Electronic Referral Loops by Receiving and Incorporating Health Information measure, included in the Health Information Exchange objective, to Support Electronic Referral Loops by Receiving and Reconciling Health Information.
- Increasing the number of electronic clinical quality measure (eCQMs) data reported from one self-selected quarter to two self-selected quarters of data.
The following requirements will remain:
- A minimum of any continuous, self-selected, 90-day electronic health record (EHR) reporting period.
- Participants must report on four objectives:
- Electronic Prescribing
- Health Information Exchange
- Provider to Patient Exchange
- Public Health and Clinical Data Exchange
- CMS will continue to implement a performance-based scoring methodology with scoring occurring for each of the individual measures.
- Report on four self-selected eCQMs of the nine available.
- Submit a “Yes” to the following:
- Security Risk Analysis measure
- Prevention of Information Blocking Attestations
- ONC Direct Review Attestation
Certified electronic health record technology (CEHRT) requirements include:
- Required use of (1) existing 2015 Edition certification criteria, (2) the 2015 Edition Cures Update criteria, or (3) a combination of the two, as finalized in the calendar year 2021 Physician Fee Schedule Final Rule (85 FR 84818 through 84828).
- CEHRT functionality must be in place by the first day of the EHR reporting period.
- EHR must be certified by ONC by the last day of the EHR reporting period.
- Must use the CEHRT functionality for the full EHR reporting period.
Below are new resources for Medicare Promoting Interoperability Program participants:
- 2021 Medicare Promoting Interoperability Program Requirements Webpage
- 2021 Medicare Hospital Specification Sheets
- 2021 Medicare Promoting Interoperability Program Requirements Infographic
- 2021 Scoring Methodology Fact Sheet
- 2021 eCQM Reporting Requirements Table
- 2021 CEHRT Fact Sheet
- Security Risk Analysis Fact Sheet
For More Information
For more information on the Medicare Promoting Interoperability Program, please visit the Promoting Interoperability Programs website