Certified EHR Technology

To efficiently capture and share patient data, health care providers need an Electronic Health Record (EHR) that stores data in a structured format. Structured data allows health care providers to easily retrieve and transfer patient information, and use the EHR in ways that can aid patient care.

The Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology (ONC) have established standards and other criteria for structured data that EHRs must meet to qualify for use in the Promoting Interoperability (PI) Programs. Once a product or system is certified, the name of the product will be listed on the ONC website, with frequent updates as new systems and products are added.

To avoid a Medicare payment adjustment or to receive a Medicaid incentive payment, health care providers must use an EHR that is certified specifically for the PI Programs. Certified EHR Technology gives assurance to purchasers and other users that an EHR system or module offers the necessary technological capability, functionality, and security to help them meet the meaningful use criteria. Certification also helps health care providers and patients be confident that the electronic health IT products and systems they use are secure, able to maintain data confidentially, and work with other systems to share information.

All participants in the Medicaid PI Program are required to use 2015 Edition Certified EHR Technology. This requirement will benefit health care providers and patients by using the most up-to-date standards and functions to better support interoperable exchange of health information and improve clinical workflows. The 2015 Edition CEHRT did not have to be implemented on January 1, 2020. However, the functionality must be in place by the first day of the EHR reporting period and the product must be certified to the 2015 Edition criteria by the last day of the EHR reporting period. The EP, EH or CAH must be using the 2015 Edition functionality for the full EHR reporting period. In many situations the product may be deployed but pending certification.

Electronic Clinical Quality Measures (eCQM) Policies for Program Year 2020

The 2020 Physician Fee Schedule (PFS) Final Rule established that in 2020, all Medicaid EPs must report on a 90-day eCQM reporting period. EPs are required to report on any six eCQMs related to their scope of practice. In addition, Medicaid EPs are required to report on at least one outcome measure. If no outcome measures are relevant to that EP, they must report on at least one other high-priority measure. If there are no outcome or high priority measures relevant to an EP’s scope of practice, they must report on any six relevant measures.

The list of available eCQMs for EPs in 2020 is aligned with the list of eCQMs available for Eligible Clinicians under the Merit-based incentive Payment System (MIPS) in 2020. Those eCQMs can be found here.