The American Recovery and Reinvestment Act of 2009 (ARRA) was signed into law by President Obama on February 17, 2009. The law includes the Health Information Technology for Economic and Clinical Health ACT (HITECH Act), which was intended to accelerate the adoption of health information technology (HIT) and the use of qualified electronic health record systems (EHRs). 

In fall 2018, CMS changed the name of the EHR Incentive Program to “Promoting Interoperability.” The Promoting Interoperability program (Meaningful Use) provides payment to eligible professionals, eligible hospitals, and critical access hospitals (CAHs) when they meet a set of standards for the use of federally certified EHR technology (CEHRT) as part of their practice. Meaningful Use was established as a progressive, 3-stage program: 

  • Stage 1: Use of CEHRT for data capturing & sharing (began in 2011 – complete) 
  • Stage 2: Use of CEHRT to advance clinical processes (began in 2014 – complete) 
  • Stage 3: Use of CEHRT to move toward improved health outcomes. At this time, all participants should adhere to the Stage 3 requirements. 

The Medicaid Promoting Interoperability program will end on September 30, 2021. The reporting period has been extended to December 31, 2021.  


Please note that the 2020 Physician Fee Schedule (PFS) Final Rule included substantive changes to Stage 3. All Eligible Providers (EPs) participating in Meaningful Use in 2021 must adhere to the following requirements: 

  • The EHR reporting period for EPs attesting in 2021 is any 90 continuous days. 
  • All participants in the Medicaid Promoting Interoperability Program must use 2015 Edition CEHRT. 
  • The eCQM reporting period is 90 days. Eligible Professionals (EPs) must report on any 6 eCQMs and 1 outcome or high-priority measure related to their scope of practice. The 2021 Medicaid Promoting Interoperability Program eCQMs are aligned with the 2021 MIPS eCQMs. EPs can choose from the eCQMs available. 


Full descriptions of the objectives are available.  

Objective 1: Protect Patient Health Information 

Objective 2: Electronic Prescribing 

Objective 3: Clinical Decision Support 

Objective 4: Computerized Provider Order Entry 

Objective 5: Patient Electronic Access to Health Information 

Objective 6: Coordination of Care through Patient Engagement 

Objective 7: Health Information Exchange 

Objective 8: Public Health and Clinical Data Registry Reporting 

For specific questions about attestation, reporting, and deadlines, EPs should contact their State Medicaid Agency’s Promoting Interoperability Program 

State Medicaid Agencies Promoting Interoperability Program Contact Information 

AAP Child Health Informatics Center (CHIC) 

The AAP Child Health Informatics Center (CHIC) was established in 2009 to support pediatricians in the effective adoption use of health information technology for high quality pediatric care. Since that time, the CHIC has provided technical assistance and support for meaningful use attestations and audits to pediatrics. Pediatricians who need assistance may contact us.

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American Academy of Pediatrics