CMS QRDA Pre-Submission Validation Tools

The Hospital Quality Reporting (HQR) System, launched in 2020, includes troubleshooting functionality in the test portion of the HQR System, such as checking for valid submission period dates and providing measure outcome information. Submitters can perform all functions for validation of CMS QRDA Category I files in the test portion of the HQR System and receive succinct and informative feedback. Users have simultaneous access to the test and production portions of the HQR System as they prepare for production QRDA Category I file submissions for eCQM reporting to the Hospital Inpatient Quality Reporting (IQR), Hospital Outpatient Quality Reporting (OQR), and Promoting Interoperability Programs. CMS retired the Pre-Submission Validation Application (PSVA) in the summer of 2020.

Topic	Cypress QRDA Validation Utility	Hospital Quality Reporting System
Quick Check	Eligible Clinicians Eligible Hospitals (EHs)/Critical Access Hospitals (CAHs) Quality Reporting Document Architecture (QRDA) Category I QRDA Category III	EH/CAHs QRDA Category I
Tool Description	A development tool for health information technology (IT) vendors testing synthetic QRDA Category I and Category III documents for conformance to the base Health Level Seven International® (HL7®) QRDA standards and Centers for Medicare & Medicaid Services (CMS) submission requirements. Cypress validates files against the standards/versions corresponding with the selected reporting/performance period. The standards listing can be found on the eCQI Resource Center Tools & Key Resources page. Cypress is made available in the early summer after the eCQMs are updated and published, refer to the Cypress Release Notes for specific dates.	The Hospital Quality Reporting (HQR) System is used by EHs and CAHs completing the eCQM reporting to the Hospital Inpatient Quality Reporting (IQR), Hospital Outpatient Quality Reporting (OQR), and/or the Medicare Promoting Interoperability programs. CMS notifies users when the receiving system is available to accept test and production QRDA Category I files. The HQR 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, OQR Program, or Promoting Interoperability credit.
How to Access	Accessible to anyone. For Performance/Reporting Period use https://cypressdemo.healthit.gov/.l	Users must login to the HQR Home Page with valid user credentials to access the File Upload card. Users verify they are on the eCQM tab and then selects Test or Production. Users have the option to select files or drag and drop the files into the highlighted area.
HL7 QRDA Version	For information about the supported Health Level Seven International® (HL7®) QRDA version, visit the Cypress Release Notes page.	Supports the required version of the HL7 QRDA Category I for the reporting period.
Accepts PHI	The public instance of Cypress does not accept personally identifiable information (PII)/ protected health information (PHI). A downloadable version of the Cypress Validation Utility + Calculation Check (CVU+) is available on GitHub.	The system can accept PII or PHI in submitted files.
CMS Programs Supported	Traditional Merit-based Incentive Payment System (MIPS) Alternative Payment Model (APM) Performance Pathway (APP) MIPS Value Pathway (MVP) Primary Care First (PCF) HQR OQR Promoting Interoperability	HQR-EHR submissions for Promoting Interoperability, IQR, and OQR programs.
Interface with CMS	None	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 Eligible Clinician and EH/CAH submissions based on CMS’s 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 CMS required validation of Authorized CMS Certification Numbers (CCNs).	Yes, the system validates HQR test and production submissions based on the CMS QRDA I IG for the applicable reporting period.
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.	Runs on the CMS HQR System. 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 files or drag and drop the files into the highlighted area.
Number of Files Validated	The uploaded file is either a zip file containing multiple files or a single XML file.	Files or zipped files. A single batch may contain up to 14,999 files.
eCQM Calculations	Displays results of eCQMs included in uploaded QRDA document.	Yes.
Error Reporting	Displays all error messages on the screen found for the entire file; identifies QRDA conformance statements in error.	Generates a CSV report with all error messages found in the entire file; reports accessible from CMS HQR System and clicking on the eCQM card following successful processing of files within batches.
Stored Results	Stores validation results and calculations for future retrieval. Results on public instance are removed weekly.	All files from submissions are stored indefinitely. They can be retrieved at any time via the CMS HQR System and clicking on eCQM card.
Other Features	None.	Test submissions through the CMS HQR System 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.	The HQR System is a shared submission system and all files are processed on a first come, first served queue.
Next Release/Update	Updated Annually: generally, 1-2 months after publication of new CMS QRDA IGs. See Cypress Release Notes and Future Release.	The HQR System is typically updated in the fall to receive the most current version of the QRDA Category I files based on the CMS QRDA I IG and Schematrons published on the eCQI Resource Center.
Support Contact	Cypress Issue Tracker	QualityNet Help Desk: 866-288-8912 (TTY 877-715-6222) 7:00 a.m.–7:00 p.m. CT M-F or qnetsupport@cms.hhs.gov. You will be asked to provide basic information such as name, practice, address, phone, and email.