Eligible Hospital Supporting Documentation: supporting documentation must be uploaded at the time of attestation. New Hampshire Medicaid reserves the right to request additional documentation such as patient volume, or average length of stay, encounter reports.

Year 1: Adopt, Implement, Upgrade Certified EHR Technology

• Certified EHR Technology Documentation: All certified modules or EHRs that are available at the EH at the start of the EHR reporting period must be added to the cart on the Office of the National Coordinator Certified Health IT Product List (CHPL) website to generate an accurate CMS EHR Certification ID. EHs must upload a screenshot of the CHPL webpage with the CMS EHR Certification ID at the time of attestation.
• Payment Documentation: Four years of Medicare Cost Report data are required at the time of attestation. This includes the most current filed hospital fiscal year report (referred to as the base year) and the previous three hospital fiscal year reports.
• CMS Submission Receipt: When an EH successfully attests for the Medicare EHR Incentive Program on the CMS website, CMS will provide a submission receipt as proof that the hospital successfully attested. This receipt must be uploaded at the time of attestation.

Year 2: Meaningful Use (MU)

• CMS Submission Receipt: When an EH successfully attests for the Medicare EHR Incentive Program on the CMS website, CMS will provide a submission receipt as proof that the hospital successfully attested. This receipt must be uploaded at the time of attestation.
• Average Length of Stay Documentation: the most recently filed Medicare Cost report data for total Inpatient Bed Days (CMS 2552-10,Worksheet S-3, Part 1, Column 8, Line 14) and total Discharges (CMS 2552 10, Worksheet S-3, Part 1, Column 15, Line 14)