CMS Posts 2014 Meaningful Use Eligible Hospital Clinical Quality Measure Update

Stage 2 CQMs for Eligible Hospitals

The following is a communication from the Office of the National Coordinator for Health Information Technology

In the final rule for Stage 2 of Meaningful Use (MU), CMS outlined the timeline for reviewing and publishing updates to the Clinical Quality Measure (CQM) specifications used in the EHR Incentive Program. CMS determined that the specifications should be updated more frequently than the rulemaking cycle for the Medicare and Medicaid EHR Incentive Programs in order to ensure that specifications maintain alignment with current clinical guidelines and ensure that the CQM remains relevant and actionable within the clinical care setting.

In addition, beginning in 2014 the CQM specifications will be used for multiple programs such as the Physician Quality Reporting Program, as a result of efforts to align incentive programs and reduce the burden on providers to report quality measures.

CMS strongly encourages the implementation and use of the updates to the electronic specifications of the CQMs finalized in the Stage 2 rule since those updates include new codes and logic corrections and clarifications. However, CMS will accept all versions of the CQMs for MU, beginning with those finalized in the December 4, 2012 CMS-ONC Interim Final Rule and including all annual updates until the Stage 3 rulemaking and the establishment of a new edition of certification criteria for EHR technology.

The updated 2014 CQMs for eligible hospitals are now available, as well as corresponding specifications for electronic reporting and access to the related data elements and value sets.

EHR CQM Certification
To participate in the EHR Incentive Program for 2014, a system must at least be certified to the specifications published with the Interim Final Rule in December of 2012. However, if a vendor or facility chooses to update their specifications to those published in the annual update, those specifications will also be acceptable for certification for participation in the program in 2014.

CMS will maintain both the December 2012 specifications and the new updated specifications for the 2014 CQMs for both eligible hospitals and eligible professionals. In addition, you can find information on the changes made in the annual update, as well as guidance for reading and programing systems with the 2014 specifications on the CMS website and new CQM Library.

Certification of EHR technologies requires that EHR software products and EHR modules be tested, as applicable, for their capabilities to accurately capture, calculate and report the Clinical Quality Measure results. Cypress is the official ONC Certification Program tool for testing these capabilities. The tool has encoded the measure logic required for testing a software implementation and updated test decks which reflect updated quality measures.

The standard expectation for updates to Certification Test Procedures, is that Accredited Testing Laboratories (ATLs) have a 30-day effective period to transition to the new procedures after they are posted on the ONC Certification website. ATLs have the option to implement the updated procedures at any time after ONC has posted. However, ONC anticipates that it will typically take a couple of weeks for an ATL to train, test and adapt the new procedure. If a vendor has begun the certification process, but has not completed testing when updated Test Procedures have become effective, the vendor should work with their ATL to ensure they are testing against the appropriate version. Individual ATLs have the option to test against the previous version of the Test Procedure or the updated version during the 30-day effective period. Any questions about the Certification program should be directed to

Updated 2014 CQM Resources
To help providers and vendors navigate the updated CQMs, the following resources are available: