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Public Health Reporting for Medicare’s Promoting Interoperability Program (PIP)

North Carolina’s state Division of Public Health (NC DPH) oversees objectives for the Centers for Medicaid and Medicare Services (CMS) Promoting Interoperability Program (formally Meaningful Use) and the Merit-based Incentive Payment System (MIPS) . Eligible clinicians participating in the MIPS program, and eligible hospitals and critical access hospitals (CAH) must meet the electronic Public Health reporting program objectives to qualify for incentive payments. The CMS Promoting Interoperability Program specification sheets for the calendar year for eligible hospitals, critical access hospitals, and eligible clinicians can be accessed through the links below.

Objectives Eligible Clinicians Eligible Hospitals/CAH
1. Electronic Reportable Laboratory Results Reporting N/A Yes pdf
2. Syndromic Surveillance Reporting Yes pdf Yes pdf
3. Immunization Registry Reporting Yes pdf Yes pdf
4. Electronic Case Reporting Yes pdf Yes pdf
5. Diabetes Specialized Public Health Registry Reporting Yes pdf Yes pdf

PIP Registration
The North Carolina Division of Public Health (NC DPH) is accepting registrations for the Medicare Promoting Interoperability Program (PIP). To meet the Public Health objectives for Medicare’s PIP, hospitals, critical access hospitals, eligible clinicians, and eligible clinician practices should follow the registration instructions below.

The User Guide provides an overview of the registration process and the information required to register for intent for each public health program. A confirmation email will be forwarded for all completed registrations. NPI numbers are required to register eligible hospitals, critical access hospitals, eligible clinicians, and eligible clinician practices.

Registration Instructions:
Step 1: Go to the NCID home page and click Register! to create and activate an NCID username and password. If you already have an NCID username and password (this is the same username and password used to login to NCMIPS), please go to step 2.
Step 2: To begin your registration of intent to participate in a public health program, login to Registration Login and enter your NCID username and password.

PIP Active Engagement 2023
CMS modified the levels of active engagement for the Public Health and Clinical Data Exchange Objective for the 2023 calendar year. The three options of active engagement were consolidated to the following two: Option I, Pre-production and Testing/Validation and Option II, Validated Production Data.

PIP Active Engagement 2022
Eligible clinicians, hospitals, and CAH’s must demonstrate active engagement by registering to submit data/pre-production (option 1); testing and validating the electronic submission data (option 2), or through submitting production data (option 3).

Medicaid Promoting Interoperability Program
The last day eligible professionals and hospitals could receive incentive payments for the Medicaid PIP program was December 31, 2021.  CMS

Public Health Promoting Interoperability Objectives

Electronic Laboratory Reporting: NC DPH accepts Electronic Laboratory Reports from hospitals eligible for PIP credit, according to the HL7 2.5.1 standards required to meet the 2015 Edition Certified Electronic Health Record Technology (CEHRT) definition. Clinicians that perform tests are required to send lab information to NC DPH. Website: NC DPH: ELR Meaningful Use Requirements (

Syndromic Surveillance Reporting: NC DPH accepts electronic Syndromic Surveillance data from eligible hospitals transmitting data according to the standards required to meet the 2015 Edition CEHRT definition. NC DPH is not requesting and will not receive electronic syndromic surveillance from eligible professionals. If ongoing submission of syndromic surveillance data was already achieved by an eligible hospital for an EHR reporting period in a prior year and continues throughout the current EHR reporting period using NCHESS, registration of intent for the syndromic surveillance measure is not required. Website: NC DPH: Syndromic Surveillance Meaningful Use Requirements (

Immunization Reporting: Starting January 1, 2018 the NC DPH Immunization Registry (NCIR) will apply the  CDC HL7 2.5.1 Implementation Guide for Immunization Messaging, Release 1.5  and Addendum to meet the 2015 Edition Certified Electronic Health Record Technology (CERHT) definition. NCIR will support Query/Response, acknowledgement messaging, and the receipt of National Drug Codes (NDC) for newly administered immunizations. Eligible clinicians using certified electronic health record software must register for the immunization registry reporting measure. Additional information will be provided for registered eligible professionals. Website: NC DPH, WCH: Immunization: NCIR Promoting Interoperability FAQs

Electronic Case Reporting: NC DPH began accepting registrations of intent for eCR from eligible hospitals and critical access hospitals (CAHs) in January 2019 and from eligible clinician groups on March 15, 2022. It utilizes the HL7 electronic initial case report (eICR) standards (R1.1 and R3) for electronic case reporting (eCR) and to support the new CMS Promoting Interoperability regulations for eCR. NC DPH requires the use of APHL AIMS and the Reportable Condition Knowledge Management System (RCKMS) to ensure appropriate reporting. Website: NC DPH: Electronic Case Reporting

Cancer Registry: Effective 1/1/2022, the North Carolina Central Cancer Registry (NCCCR) is no longer participating in the Medicare and Medicaid Promoting Interoperability Program. Eligible clinicians that manage, detect, diagnose, or treat patients with reportable cancers and conditions must report directly to the NCCCR.  Information on how to meet the NCCCR reporting requirements can be found on the  Physician Practice Reporting  page. For information about direct reporting, please contact at the NC Central Cancer Registry.

Diabetes Specialized Public Health Registry: Effective June 1, 2018, the NC Diabetes Specialized Public Health Registry will be available for population health purposes. Full participants of NC HealthConnex are eligible to participate in the registry by signing the NC HealthConnex Diabetes Registry Form. Data submitted to NC HealthConnex will be included in the Diabetes Registry, as appropriate. No additional data submission from participants is required. The NC HealthConnex Diabetes Registry supports attestation for Promoting Interoperability for eligible hospitals, eligible critical access hospitals, and eligible clinicians, and Medicare Quality Payment Program Advancing Care Information for eligible clinicians. Information about becoming a full participant of NC HealthConnex and the diabetes specialized registry is available on the following website: N.C. Diabetes Specialized Public Health Registry | NC HIEA . Questions can be directed to:

Contact Information
Send an email to North Carolina’s Division of Public Health for additional information regarding PIP requirements at

Additional Resources