The Centers for Medicare and Medicaid Services (CMS) has proposed significant steps to align CMS reporting programs with recently proposed changes to the ONC Certification Program.

In the FY2027 Inpatient Prospective Payment System (IPPS) Proposed Rule published in the Federal Register on April 14, 2026, CMS changed requirements eligible hospitals must meet to be “Meaningful Users” of health IT to avoid a negative payment adjustment for their Medicare reimbursement.

Proposed changes included:

• Changing the definition of “certified health IT” to remove or revise certification criteria proposed for removal in ONC’s HTI-5 proposed rule
• Removing "Support Electronic Referral Loops" measures and requiring hospitals to exchange information using TEFCA or HIE Bi-Directional Loops starting in 2028
• Adding a new measure requiring the use of Unique Device Identifiers (UDI) for implantable medical devices, enhancing the ability to track patient safety and device performance digitally

In addition, CMS proposed electronic clinical quality measure (eCQM) reporting mandates for quality measures related to hospital harm and malnutrition events starting in 2028. These proposals are viewed as first steps toward transitioning all CMS programs to FHIR-specified digital quality reporting. At HIMSS26 and the CMS Quality Conference, CMS had shared that all eCQMs have been respecified to FHIR, and that CMS will launch a voluntary digital quality measure reporting program in future rulemaking.

HIMSS has long supported the transition to digital quality reporting, provided measures required for reporting:

• have been robustly tested in diverse care delivery environments and been deemed feasible and accurate assessments of care
• generate actionable information that providers can utilize to address care gaps in as close to real time as possible
• are not overly burdensome to collect

HIMSS has created a detailed fact sheet on the proposed rule and will be issuing comments before the CMS public comment deadline of June 9, 2026. If HIMSS members have feedback on the proposed rule, please send your comments to jonathan.french@himss.org.