Introduction
The Centers for Medicare & Medicaid Services (CMS) publishes annual updates to public health reporting requirements for eligible clinicians (ECs) participating in the Merit-based Incentive Payment System (MIPS) and eligible hospitals (EHs) and critical access hospitals (CAHs) participating in the Medicare Promoting Interoperability Program (PIP).
For calendar year 2026, the Medicare Promoting Interoperability Program for Eligible Hospitals (EH) and Critical Access Hospitals (CAH) requires active engagement in six Public Health and Clinical Data Exchange Objective measures: Syndromic Surveillance Reporting, Immunization Registry Reporting, Electronic Case Reporting, Electronic Reportable Laboratory Result Reporting, Antimicrobial Use Surveillance, and Antimicrobial Resistance Surveillance.
The 2026 MIPS Promoting Interoperability Performance Category for Eligible Clinicians includes two required measures associated with the Public Health and Clinical Data Exchange Objective: Immunization Registry Reporting, and Electronic Case Reporting.
Please see CMS’s Promoting Interoperability Programs website for more detailed information about each program.
Syndromic Surveillance Reporting
Massachusetts Department of Health (DPH) accepts syndromic surveillance data from eligible hospitals, critical access hospitals and urgent care settings.
Only eligible clinicians (ECs) practicing in a freestanding urgent care facility currently qualify for this optional MIPS measure because the DPH will only accept urgent care syndromic surveillance data from eligible hospitals and freestanding urgent care facilities.
Successful attestation for this measure requires registration of intent to submit syndromic data within 60 days of start of the reporting period and one of the following: 1) has achieved ongoing submission, 2) is engaged in testing and validation or is awaiting invitation to begin testing and validation.
DPH participates in the National Syndromic Surveillance Program (NSSP) and uses ESSENCE for aggregation and analysis of syndromic surveillance data; data are held in the Amazon Web Services Cloud. The state-wide Health Information Exchange (Mass HIway) serves as the infrastructure to aggregate and send data to the NSSP. This data transmission is in accordance with the standards set forth by the Office of the National Coordinator in order to meet promoting interoperability requirements for syndromic surveillance.
Syndromic surveillance data must comply with the PHIN Messaging Guide for Syndromic Surveillance (PDF).
For programmatic information about Syndromic Surveillance and to register intent to submit Syndromic Surveillance data for Promoting Interoperability at syndromic-surveillance@mass.gov.
Immunization Reporting
The Massachusetts Immunization Information System (MIIS) is available to receive electronic messages from eligible clinicians for Promoting Interoperability purposes. The MIIS accepts electronic immunization messages (VXU) and bi-directional data exchange (QBP/RSP) in the HL7 2.5.1 format from certified electronic health record systems. Detailed technical specifications and other information for electronically exchanging data with the MIIS are available on the MIIS Onboarding page. Additional technical information is available upon request.
The statewide Health Information Exchange (Mass HIway) serves as the infrastructure to accept data from existing EHR systems in real time, eliminating the burden of duplicate entry into your system and into MIIS. The Mass HIway accepts HL7 version 2.5.1 messages and fulfills the applicable Promoting Interoperability measure. Learn about how to enroll in the Mass HIway.
Please note that pursuant to M.G.L. Chapter 111, Section 24M all licensed health care providers that administer immunizations are required to report immunization data to the MIIS.
For more information, and to formally register intent to submit immunization data, please contact the MIIS Help Desk: (617) 983-4335 or miishelpdesk@mass.gov.
Electronic Case Reporting (eCR)
The Massachusetts Department of Public Health accepts electronic case reports for diseases dangerous to the public, in accordance with 105 CMR 300.000 (Reportable Diseases Surveillance and Isolation Requirements).
DPH uses Health Level 7 (HL7) Electronic Initial Case Report (eICR) and Reportability Response (RR) standards for electronic case reporting (eCR) and requires use of the RCKMS Decision Support & Authoring for reporting. Submission of eCR to DPH satisfies the requirements for PIP and MIPS Promoting Interoperability Electronic Case Reporting performance measures. eCR also contributes to reportable disease surveillance and case investigation.
Please note the following requirements for active engagement with DPH for eCR:
- Ensure that your Electronic Health Record (EHR) or Health IT product can support the eICR R3.1.1 implementation guide (HL7 CDA* R2 Implementation Guide: Public Health Case Report – the Electronic Initial Case Report (eICR) Release2, STU Release 3.1.1 – US Realm
- All existing eICR R1.1 senders should update to eICR R3.1.1 as soon as possible and no later than December 31, 2026.
- Any new EHR product eCR implementation after June 1, 2026, must use eICR R3.1.1.
- Senders must conduct full triggering of eICRs (i.e., triggering for all conditions) by implementing Electronic Reporting and Surveillance Distribution (eRSD) version 3 or higher.
- All existing senders triggering for a limited set of conditions must implement eRSD version 3 with full triggering by December 31, 2026.
For more information about engagement with DPH for eCR, please contact ImmediateDiseaseReporting@mass.gov.
General information about electronic case reporting can be found on the AIMS eCR - Electronic Case Reporting and CDC’s Electronic Case Reporting (eCR) | eCR | CDC websites.
Electronic Laboratory Reporting (ELR)
Electronic Laboratory Reporting is a secure, automated mechanism for the reporting of laboratory and patient information by hospitals and commercial laboratories. ELR is mandated in accordance with 105 CMR 300.170 (Laboratory Findings Indicative of Infectious Disease reportable Directly to the Department by Laboratories).
The Massachusetts Health Information Reporting Portal (HIRP) is available to receive electronic messages from eligible providers for Promoting Interoperability purposes. The HIRP accepts electronic laboratory result reports in the HL7 2.5.1 format from certified electronic health record systems. Additional technical information is available upon request.
Please review Infectious Disease Reporting and Regulations for Health Care Providers and Laboratories to see if your facility is exempt from reporting ELR performed on-site.
DPH will accept HL7 2.5.1 ELR via the statewide Health Information Exchange (Mass HIway) or SFTP.
For more information, please contact ELR.CDSupport@mass.gov.
Antimicrobial Use (AU) and Antimicrobial Resistance (AR) Surveillance
Eligible hospitals and CAHs must attest to being in active engagement with CDC’s NHSN to submit both AU and AR data for the EHR reporting period or claim an applicable exclusion. Further, to meet the CMS PI Program requirement, facilities must use CEHRT updated to meet 2015 Edition Cures Update criteria, including criteria at 45 CFR 170.315 (f)(6).
Please see to the NHSN’s FAQs: AUR Reporting for the CMS Promoting Interoperability Program website for more information, including CY-specific submission requirements.
Public Health Registry (Optional)
Cancer Registry
The Public Health Registry and Clinical Data Registry Reporting objective includes a measure related to reporting to Public Health Registry, which includes Cancer Reporting by ECs only to State Cancer Registries.
The Massachusetts Cancer Registry supports cancer reporting from ambulatory providers/ECs. Cancer reporting is part of the Centers for Medicare and Medicaid Services Promoting Interoperability Programs. The CDC provides an overview on reporting to Public Health Registries in Public Health Registries Reporting | PHDI | CDC.
An EHR system must meet 2015 certification criteria 170.314(F)(4) Transmission to Cancer Registries to be considered Certified EHR Technology for cancer reporting. For more information, please review the Implementation Guide.
If you diagnose and/or treat cancer patients in an ambulatory setting in Massachusetts and would like to report cancer cases for Promoting Interoperability, register with the Massachusetts Cancer Registry by the 60th day of your reporting period. You must have Certified EHR Technology that can produce cancer CDA messages. For registration or questions, please contact the Cancer Registry’s Operations Manager, Nancy Klein, at nancy.klein@mass.gov.
Clinical Data Registry Reporting (Optional)
The Massachusetts Department of Public Health does not currently host any Clinical Data Registries that qualify for Promoting Interoperability requirements.
Mass HIway
The Massachusetts Department of Health (DPH) and the Mass HIway have partnered to transition all public health data reporting to the secure, statewide health information exchange (HIE). The key goals of this are to automate the data import process, simplify the administrative process, and remove as many manual interventions on the data as possible. This can also reduce cost for providers by maintaining fewer reporting interfaces. For more information about the Mass HIway and how to enroll, please visit the Massachusetts Health Information HIway website.