Eligible Hospitals - Required Documentation

Eligible Hospitals are required to attest to meeting all program requirements when completing an application, including program eligibility criteria and patient volume requirements. Eligible Hospitals must submit documentation to support their attestation in addition to the information entered on their application (regardless of their stage of Meaningful Use).

Wisconsin Medicaid requires all Eligible Hospitals to upload their supporting documentation directly to their application and also reminds participants they should maintain supporting documentation for the Wisconsin Medicaid EHR Incentive Program application in their files for six years post-attestation. For specific instructions on how to upload documentation, Eligible Hospitals should refer to the Wisconsin Medicaid Electronic Health Record Incentive Program User Guide for Eligible Hospitals.

Certified EHR Technology Documentation Requirements

All Eligible Hospitals must submit at least one of the following documents to support the acquisition of 2014 or 2015 Edition CEHRT:

  • Contract
  • Lease
  • Proof of purchase
  • Receipt
  • Signed vendor letter

All of the following must be identified on the submitted CEHRT documentation, regardless of format:

  • Vendor
  • Product
  • Product version number
  • Indication that CEHRT was adopted, implemented, upgraded, or in use during the Program Year for which the hospital is applying

Submission Requirements for Supporting CEHRT Adoption

Each Eligible Hospital is required to upload supporting documentation to their application.

Medicare Cost Report Data Documentation Requirements

Refer to the existing Eligible Hospital – Incentive Payment page for details on this required documentation.

Last Revised: June 19, 2017