BACKGROUND: HT-1 will come into effect Jan 2026. We have been investigating HT-1 and its effects on our stakeholders. ONC’s stance is to use US Core 4.0.0 as the base level ( for USCDI v1) and then approve the latest SVAP version aligned with the latest version of USCDI. See the SVAP link below, for ONC’s published requirements for US Core : https://www.healthit.gov/topic/standards-version-advancement-process-svap The link contains the text that displays the stance that ONC will allow USCORE 4.0.0 version for certification to USCDI v1 ( and not 3.1.1) "Additionally, the SVAP approved standard of HL7® FHIR® US Core Implementation Guide STU 4.0.0, June 2021 will continue to remain available for certification via SVAP while the United States Core Data for Interoperability (USCDI), Version 1, July 2020 Errata remains available for use in the Certification Program as a standard adopted in regulation." USCORE 3.1.1 is still allowed for certification because it is in the cures regulations until HTI-1 becomes the regulatory floor. But ONC have kept the 4.0.0 version in SVAP to align with USCDi v1 since 3.1.1 had issues. The issues are with differences in terminology bindings. ACTION: We are looking to see if we can adopt USCORE 4.0 or USCORE 6.1.1 in the STU2 version. There should be a minimal direct effect on data covered directly by the IG as the IG was made compatible with USCORE 7 before the ballot. There are accessory features in later USCORE versions that touch on items beyond the eLTSS IG Update's scope of the eLTSS DAM data elements, such as the US Core Observation Occupation Profile.