The Centers for Medicare & Medicaid Services (CMS) requires that all CAHs use 2015 Edition certified electronic health record technology (CEHRT) to meet the requirements of the Promoting Interoperability Programs. If a CAH can provide proof that meeting this requirement results in a significant hardship, they can apply for a hardship exception, which is valid for only one payment adjustment year. CAHs that do not meet the requirement and do not get a hardship exception will have a downward payment adjustment. Find more information here.