For the 2016 reporting period, the PQRS Submission Engine Validation Tool (SEVT) will validate EP submitted files in phases in order to more accurately describe error and warning messages as either violating the base HL7 QRDA standards, 2016 CMS QRDA Implementation Guide specifications, or 2016 PQRS specific rules (PQRS_Pxxxx). Thus, errors and warnings will be generated according to the following hierarchy:
This guidance will be included in the 2017 CMS QRDA Eligible Clinician Implementation Guide.
1) All QRDA files must be valid to the HL7 CDA Schema (CDA_SDTC.xsd). If the submission is not schema valid then the file is rejected and no further validation occurs.
2) Schema valid files are then validated against the 2016 CMS IG Schematron rules which cover the Base 2016 HL7 IG constraints plus the constraints in the 2016 CMS QRDA IG, minus the constraints in the Patient Data Level appendix.
a. If errors are encountered (i.e. violations of SHALL constraints) then the file is rejected and no further validation occurs.
3) Submissions that are still valid after the first two phases (but they may include warning from the second phase) then go through a third level of validation occurs. The following User Guides describe the third level of validation for the PQRS program:
a. There are links to these user guides on the PQRS QualityNet portal. The two relevant guides for this third phase are the following:
i. PQRS SEVT User Guide (the current version is "Physician Quality Reporting System (PQRS) Program Year 2016 Submission Engine Validation Tool (SEVT) User Manual, Version: 2.0 04/15/2016") and
ii. PQRS Submissions User Guide (TBD… last year the title was "Physician Quality Reporting System (PQRS), Program Year 2015, Submission User Guide, Version: 2.0, 12/18/2015").
QRDA ONC Jira ticket: QRDA-325