Skip to main content
U.S. flag

An official website of the United States government

Return to Search

Puerto Rico Hospitals

Guidance for Puerto Rico hospitals under the Promoting Interoperability Program.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: April 20, 2020

Section 602 of the Consolidated Appropriations Act of 2016 amended section 1886(n)(6)(B) of the Act to include subsection (d) Puerto Rico hospitals 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 2017
    • Payments received: FYs 2017-2020
  • First payment year: FY 2018
    • Payments received: FYs 2018-2021

Reporting Requirements for Medicare Hospitals and Critical Access Hospitals (CAHs)

In 2020, eligible hospitals, CAHs, and dual-eligible hospitals attesting to CMS are required to report on four objectives. The 2020 Medicare specification sheets can be found here (PDF).

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.