1. EHR Incentive Program 2018 Program Requirements

2. Overview Introduction to the EHR Incentive Program
Brief Tutorial on How to Attest
Supporting Documentation List
Explanation of Meaningful Use
Update on Program Year Changes
Review Process Overview
List of Common Attestation Mistakes
Contact Information for Issues

3. EHR Incentive Program
Government Program through Centers for Medicare and Medicaid Services (CMS)
Encourage Uptake of Electronic Health Records
Six Year Program
Adopt, Implement, Upgrade (1 year)
Meaningful Use
Program continues through Program Year 2021
As of Program Year 2017, the EHR Incentive Program is no longer accepting first time attesters (AIU) into the program.
In 2018, eligible hospitals and eligible professionals (EPs) that attest directly to a state for the state’s Medicaid Electronic Health Record (EHR) Incentive Program will continue to attest to the measures and objectives as finalized in the 2015 EHR Incentive Programs Final Rule.

4. Promoting Interoperability
CMS is dedicated to improving interoperability and patients’ access to health information. To better reflect this focus, CMS is renaming the EHR Incentive Programs to the Promoting Interoperability (PI) Programs. Through this rulemaking, CMS is also streamlining the programs to reduce the time and cost required of providers to participate. Stay tuned for more information.

5. How to Attest Attest by visiting the MAPIR website
System will prompt attester for certain necessary information
Attester will need to select stage (for 2018, stage 2 or 3)
Attester will need to upload supporting documentation
Checklist of Supporting Documentation available on AIMS website

6. 2018 Stage 2
All providers participating in the EHR Incentive Program have the option of attesting to Modified Stage 2 for 2018.
10 Meaningful Use Objectives
Protect Patient Health Information 
Clinical Decision Support 
Computerized Provider Order Entry (CPOE) 
eRx 
Health Information Exchange 
Patient Specific Education 
Medication Reconciliation 
Patient Electronic Access 
Secure Messaging 
Public Health Reporting 
Certified EHR Technology from 2014 or 2015 edition, or a combination of the two.
The EHR reporting period for Meaningful Use is 90 days and Clinical Quality Measures (CQMs) for all participants is 365 days (except for first time meaningful users).  
For more information, see 2018 CMS Stage 2 Guidelines

7. 2018 Stage 3 Meaningful Use 8 Meaningful Use Objectives
Protect electronic protected health information
ePrescribing (eRx)
Clinical Decision Support (CDS)
Computerized provider order entry (CPOE)
Patient electronic access
Coordination of care
Health Information Exchange
Public Health Reporting
Certified EHR Technology from 2015 only
Some exceptions made for a mix of 2014 and 2015 technology as long as MU requirements can be met
The EHR reporting period for Meaningful Use is 90 days and Clinical Quality Measures (CQMs) for all participants is 365 days (except for first time meaningful users).  
For more information, see 2018 CMS Stage 3 Guidelines

8. Review Process After submission, a review process begins: Reviewers:
UConn HIT staff
SRA: Myers and Stauffer LLC
with issues will be sent to all listed contacts post-review
Attester will revise attestation and resubmit if necessary
Review continues until all issues resolved
After issues are resolved, the review is considered complete
Payment is typically issued in the next financial cycle which can be up to 2 weeks from the completion date.

9. Supporting Documentation
CEHRT Page
EHR Technology certification ID
Generated by Office of National Coordinator (
2014 edition or later for Stage 2
2015 edition only for Stage 3
Invoice or Purchase Order
Shows proof of purchase
NOT License Agreement
Security Risk Analysis (SRA)
Includes date of analysis done in 2018
Patient Encounter List (PEL)

10. Supporting Documentation
Patient Encounter List (PEL)
Excel file format
Must contain all columns specified in template (see AIMS website)
90 Days of data
No duplicate encounters
“One provider, one patient, one day”
Must contain 30% or more Medicaid patients by volume (20% for Pediatricians)
If attesting as group, PEL must be same for entire group

11. Meaningful Use Meaningful Use Documents Meaningful Use (MU) Objectives
90 days worth of information for all providers generated by CEHRT
Clinical Quality Measures (CQMs)
365 days worth of data generated by CEHRT (can be 90 days for 1st time meaningful users
Immunization Registry for EPs who administer immunizations to patients 0-6
MUST Portal certificate from previous program year (2015 or 2016)
If EP does not have a MUST certificate from prior years, contact Diane Fraiter at DPH for registration: or
Registration Confirmation for additional specialized registries

12. Common Attestation Errors
PEL is not in the required format (see AIMS website)
PEL contains duplicate encounters (same patient, same day, same provider)
Missing Supporting Documentation (see AIMS website for list)
CEHRT ID put in MAPIR different than ONC provided CEHRT Page
SRA from wrong program year or no SRA completed at all (SRA must be from 2018 for PY2018)
Supporting documentation numbers do not match numbers entered into MAPIR (PEL and CEHRT Report)
Objective 8: Patient Electronic Access
Objective 9: Secure Messaging

13. Common Errors: Patient Electronic Access Objective
Objective 8 (Stage 2)
Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP.
Providers that have trouble meeting this measure may use all 365 days worth of data for the numerator and a denominator from their 90 days. Providers may send information to patients during their appointment and have the patient open the information on their own devices.
Measure 1: More than 50% of all unique patients seen by the EP during the EHR reporting period are provided timely access to view online, download, and transmit to a third party their health information subject to the EP’s discretion to withhold certain information
Measure 2: For an EHR reporting period in 2018, more than 5% of unique patients seen by the EP during the reporting period view, download or transmit to a third party their health information during the reporting period.

14. Common Errors: Patient Electronic Access Objective (cont’d)
Objective 5(Stage 3): Patient Electronic Access
The EP provides patients with timely electronic access to their health information and patient-specific education
Measure 1: For more than 80% of all unique patients seen by the EP:
The patient is provided timely access to view online, download and transmit his/her health information; and
The provider ensures the patient’s health information is available for the patient to access using any application of their choice that is configured to meet the technical specs of the Application Programming Interface (API) in the provider’s CEHRT
Measure 2: The EP must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide electronic access to those materials to more than 35% of unique patients seen by the EP during the EHR reporting period.

15. Common Errors: Secure Messaging Objective
Objective 9 (Stage 2)
Use secure electronic messaging to communicate with patients on relevant health information.
Providers that have trouble meeting this measure may use all 365 days worth of data for the numerator and a denominator from their 90 days. Providers need only send secure messages. The messages do not need to be opened by the patient.
For more than 5% of unique patients seen by EP during reporting period, a secure message was sent using the electronic messaging function of CEHRT to the patient or in response to a secure message sent by the patient during the EHR reporting period.
Exclusion: Any EP who has no office visits during the reporting period.

16. More Information
Center for Medicaid and Medicare Service website (cms.gov)
UConn HIT support website (AIMS)
Department of Social Services (ctdssmap.com)
If you have questions that those sites cannot answer contact:
For MAPIR technical issues: DXC
1 (855)
For program and attestation issues: UConn HIT staff
1 (844)

17. Questions?