CMS QRDA Pre-Submission Validation Tools Guide

Quick Check

ü Eligible Clinicians/Eligible Professionals (EPs)
ü Eligible Hospitals (EHs)
ü Quality Reporting Document Architecture (QRDA) Category I
ü QRDA Category III

Tool Description

A development tool for Health information technology (IT) vendors who are testing synthetic QRDA Category I and Category III documents for conformance to the base Health Level Seven International (HL7) QRDA standard and Centers for Medicare & Medicaid Services (CMS) submission requirements.

Validates files against the base HL7 Implementation Guide (IG), or for the EH or the EP/Eligible Clinician constraints as specified in the 2016, 2017 and 2018 CMS QRDA Category I and QRDA Category III IGs.

PSVA is a client-side application programming interface (API) which provides vendors, hospitals, and providers with a method for validating electronic Clinical Quality Measure (eCQM) files within their own system/environment prior to submission and securely transport valid files to the CMS. The PSVA tool assists vendors, hospitals and providers in identifying and correcting QRDA Category I file format errors for test and production files prior to data submission to the CMS eCQM data receiving system via the QualityNet Secure Portal. The PSVA tool has three interfaces as part of the download package where the user is able to select the option that best meets their needs. The PSVA tool can be accessed on the QualityNet Secure Portal.

CMS data receiving system used by EHs and critical access hospitals (CAHs) that are reporting eCQMs under the Medicare Promoting Interoperability or the Hospital Inpatient Quality Reporting (IQR) Program. CMS notifies users when the receiving system is available to accept test and production QRDA Category I files. The CMS data receiving system performs the same validation and measure calculations for test files and production files, although only production files are submitted to meet program data submission requirements.

Note: eCQM files submitted to the test system will not be reviewed or evaluated for IQR Program or Promoting Interoperability credit.

How to Access

Accessible to anyone at https://cypressvalidator.healthit.gov/

Users must login to the QualityNet Secure Portal with valid user credentials to download the PSVA tool. Click Secure File Transfer on the top bar of the Landing Page to navigate to Secure File Transfer. Click the PSVADOWNLOAD directory in the Navigation Section of Secure Transport on the left pane. The PSVA_Installer.exe then appears in the details section on the right pane. After the initial PSVA tool download, the user will install the PSVA tool in their client environment. Users can also refer to the PSVA User Manual. 

Users must login to the QualityNet Secure Portal with valid user credentials to access the Secure File Transfer link. Users can then select the folders DataUpload > testdata > ehrqrda to submit test files into the CMS Receiving System.

HL7 QRDA Version

Supports QRDA Category I R3, R3.1 and R4. Supports QRDA Category III R1, R1.1, and R2.1.

Currently validates QRDA Category I R3

Currently validates QRDA Category I R3

Accepts PHI

https://cypressvalidator.healthit.gov/  does not accept personally identifiable information (PHI)/ protected health information (PII). A downloadable version of the Cypress Validation Utility is available by itself or with Cypress v3.

CMS Programs Supported

Interface with CMS

None

Can transmit validated files to CMS through a secure Axway interface via secure file transport protocol (SFTP) to both the TEST and PROD system.

This is the official CMS submission system and is completely integrated into the CMS infrastructure. All files that pass test submissions validation will pass production submission validation.

Validates CMS Rules

Yes, for EP/Eligible Clinician and EH submissions based on CMS’s 2016, 2017, and 2018 QRDA Category I and QRDA Category III IGs.  However, it does not perform all validations that occur on the official CMS systems. Cypress does not perform the following CMS required validations:

* Authorized CMS Certification Numbers (CCNs)

* Specific checks for Clinical Data Abstraction Center (CDAC) users

Yes, for HQR based on CMS 2019 IG. However, it cannot perform all validations that occur within the official CMS data receiving systems. PSVA does not performing the following CMS required validations:

* Authorized CCNs

* Neutral and Version Specific ID values

* Discharge dates and reporting parameters checks with allowable submission periods

* Specific checks for CDAC users

Operating Environment

Hosted on a public server maintained by the Agency for Healthcare Research & Quality. Amazon Machine Image (AMI) and Virtual Machine (VM) available for download as standalone or alongside Cypress certification tool.

Supported on Windows, operating systems only, requires Java Runtime Environment (JRE) V1.7 on the client machine, and lists the minimum hardware system requirements.

The PSVA tool is updated with the latest approved JRE V1.8.0_202.

This PSVA release updates the JRE to maintain compliance and removes security vulnerabilities within the currently bundled version of the tool.

At a minimum PSVA required JRE 1.7, but since the JRE is now bundled, the user no longer needs to have it downloaded.

Runs on the CMS Hospital Quality Reporting site (accessed via www.Qualitynet.org). This is a secure environment running in the CMS Data Center. No tools are necessary other than a standard PC with a supported web browser.

File Upload Process

Upload one file at a time to the Cypress Validation Utility.

Select file from local environment.

Drag and drop to upload file within the Hospital Reporting File Submission Process.

Number of Files Validated

The uploaded file is either a zip file containing multiple files or a single XML file.

Zip file containing up to 15,000 (QRDA) files, for a maximum uncompressed size totaling 4GB.

Files or zipped files. A single batch may contain up to 15,000 files.

eCQM Calculations

None

Yes

Error Reporting

Displays all error messages on the screen found for the entire file; identifies QRDA statements in error.
Does not store the file nor the validation results for future retrieval.

Generates a CMS feedback report upon validation with all error messages, found in the entire file. The report is accessible within the application window as soon as file validation completes.

Stores the results locally on the Provider or Vendor's equipment.

Generates a report with all error messages found in the entire file; reports accessible from QualityNet following successful processing of files within batches.

Stored Results

Does not store the file nor the validation results for future retrieval.

Stores the results locally on the Provider or Vendor's equipment.

All files from submissions are stored indefinitely. They can be retrieved at any time via a variety of reports available within the QualityNet Secure Portal

Other features

None

Transmits validated files to CMS through a secure Axway interface.

Test submissions through the CMS QualityNet Secure Portal are identical to the production submissions in terms of validation and measure calculation. A vendor or provider will know exactly what the production results will be for a QRDA by using the test submission feature in the secure portal.

Other Comments

None

Latest Production version, PSVA 1.3.5.0, was released September 18, 2019.

The CMS QualityNet Secure Portal is a shared submission system, and all files are processed in a first come, first serve queue. A time delay in having results available in reports can be impacted by the volume of submissions occurring at a given time.

Next Release/

Update

Updated Annually: generally 1-2 months after new CMS QRDA IG published in July.

Support for the 2018 CMS QRDA Category I IG was added on July 27, 2017.  Support for the 2018 CMS QRDA Category III IG was added on December 14, 2017. Support for the 2019 CMS IGs are targeted for summer 2018.

Updated Annually: generally 1-2 months after new CMS QRDA IG publishes in July.

A new program name HQR_IQR_VOL has been added so that the voluntary submissions for the new Hybrid HWR measure can be separated from other eCQM submissions due to the utilization of different system processing pathways.

Two additional program names were added for the 2019 submissions – HQR_PI and HQR_PI_IQR.

The HQR_IQR_VOL, HQR_PI and HQR_PI_IQR have been added to the program select drop-down in the PSVA guide.

The CMS receiving system is typically updated in the spring to receive the most current version of QRDA Category I files based on the CMS QRDA IG and Schematrons published on the eCQI Resource Center.

Support Contact

QualityNet Help Desk: 866-288-8912 (TTY 877-715-6222) 7:00 a.m.–7:00 p.m. CST M-F or qnetsupport@hcqis.org You will be asked to provide basic information such as name, practice, address, phone, and e-mail.