CMS QRDA Pre-Submission Validation Tools

The Hospital Quality Reporting (HQR) System 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 will be able to perform all functions for validation of QRDA Category I files in the test portion of the HQR System and receive more succinct and informative feedback. Users will 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 IQR and Promoting Interoperability Programs. CMS retired the Pre-Submission Validation Application (PSVA) in the summer of 2020.

A pdf of the table is available.

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 who are 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 that are completing eCQM reporting to the Hospital Inpatient Quality Reporting (IQR) 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 or Promoting Interoperability credit.
How to Access	Accessible to anyone. For Performance/Reporting Period use https://cypressdemo.healthit.gov/.	Users must login to the HQR Home Page-CMS: https://hqr.cms.gov/hqrng/login with valid user credentials to access the File Upload card. Users will verify they are on the eCQM tab and then the user will select Test or Production. Users will have the option to select files or drag and drop the files into the highlighted area.
HL7 QRDA Version	Supports QRDA Category I R5.2. Supports QRDA Category III R2.1.	Supports QRDA Category I R5.1.
Accepts PHI	The public instance of Cypress (https://cypressdemo.healthit.gov/) does not accept personally identifiable information (PII)/ protected health information (PHI). A downloadable version of the Cypress Validation Utility + Calculation Check (CVU+) is available with Cypress v6.	The system can accept PII or PHI in submitted files.
CMS Programs Supported	Comprehensive Primary Care Plus (CPC+) Merit-based Incentive Payment System (MIPS) Primary Care First (PCF) HQR Promoting Interoperability	HQR-EHR submissions for Promoting Interoperability and IQR 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 EP/Eligible Clinician and EH/CAH submissions based on CMS’s 2021 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 CMS 2021 QRDA I IG.
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 (accessed via https://hqr.cms.gov/hqrng/login). 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 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. Support for the 2021 CMS QRDA Category I and QRDA Category III IGs was added on July 23, 2020.	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	https://oncprojectracking.healthit.gov/support/projects/CYPRESS/summary	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 e-mail.