2027 cms iii

Gemfile

@@ -20,7 +20,7 @@ gem 'mustache'
 
 gem 'cqm-models', '~> 4.2.0'
 gem 'cqm-parsers', '~> 4.1.1.2'
-gem 'cqm-reports', '~> 4.1.6'
+gem 'cqm-reports', git: 'https://github.com/projecttacoma/cqm-reports', branch: '2027_CMS_III'
 gem 'cqm-validators', '~> 4.0.6'
 
 # # Use faker to generate addresses

Gemfile.lock

@@ -1,3 +1,20 @@
+GIT
+  remote: https://github.com/projecttacoma/cqm-reports
+  revision: 99d87fcaee37c84b0fd3d530633cd4125d47b686
+  branch: 2027_CMS_III
+  specs:
+    cqm-reports (4.1.8)
+      cqm-models (~> 4.0)
+      cqm-validators (~> 4.0)
+      erubis (~> 2.7)
+      log4r (~> 1.1)
+      memoist (~> 0.9)
+      mongoid-tree (> 2.0)
+      mustache
+      nokogiri (>= 1.16.2)
+      uuid (~> 2.3)
+      zip-zip (~> 0.3)
+
 GEM
   remote: https://rubygems.org/
   specs:
@@ -170,17 +187,6 @@ GEM
       typhoeus
       uuid (~> 2.3.7)
       zip-zip (~> 0.3)
-    cqm-reports (4.1.6)
-      cqm-models (~> 4.0)
-      cqm-validators (~> 4.0)
-      erubis (~> 2.7)
-      log4r (~> 1.1)
-      memoist (~> 0.9)
-      mongoid-tree (> 2.0)
-      mustache
-      nokogiri (>= 1.16.2)
-      uuid (~> 2.3)
-      zip-zip (~> 0.3)
     cqm-validators (4.0.6)
       nokogiri (>= 1.16.2)
     crack (1.0.1)
@@ -333,7 +339,7 @@ GEM
       thor (>= 0.14, < 2.0)
     jquery-ui-rails (8.0.0)
       railties (>= 3.2.16)
-    json (2.19.4)
+    json (2.21.1)
     kaminari-core (1.2.2)
     kaminari-mongoid (1.0.2)
       kaminari-core (~> 1.0)
@@ -385,7 +391,7 @@ GEM
       ruby-progressbar
     mocha (3.1.0)
       ruby2_keywords (>= 0.0.5)
-    mongo (2.24.0)
+    mongo (2.24.1)
       base64
       bson (>= 4.14.1, < 6.0.0)
     mongoid (9.0.11)
@@ -712,7 +718,7 @@ DEPENDENCIES
   codecov
   cqm-models (~> 4.2.0)
   cqm-parsers (~> 4.1.1.2)
-  cqm-reports (~> 4.1.6)
+  cqm-reports!
   cqm-validators (~> 4.0.6)
   csv (~> 3.3, >= 3.3.5)
   cucumber-rails

app/models/cms_program_task.rb

@@ -54,6 +54,9 @@ def ep_program_specific_validators
     return app_plus_indiv_validators if product_test.cms_program == 'APP_PLUS_INDIV'
     return app_plus_group_validators if product_test.cms_program == 'APP_PLUS_GROUP'
     return app_plus_entity_validators if product_test.cms_program == 'APP_PLUS_APMENTITY'
+    return asm_indiv_validators if product_test.cms_program == 'ASM_INDIV'
+    return asm_group_validators if product_test.cms_program == 'ASM_GROUP'
+    return lead_apm_entity_validators if product_test.cms_program == 'LEAD_APM_ENTITY'
 
     []
   end
@@ -153,6 +156,18 @@ def mips_subgroup_validators
     ep_validators
   end
 
+  def asm_indiv_validators
+    ep_validators
+  end
+
+  def asm_group_validators
+    ep_validators
+  end
+
+  def lead_apm_entity_validators
+    ep_validators
+  end
+
   # Common validators for EH programs
   def eh_validators
     [::Validators::CMSQRDA1HQRSchematronValidator.new(product_test.bundle.version, as_warnings: false),

app/models/cms_program_test.rb

@@ -9,6 +9,7 @@ class CMSProgramTest < ProductTest
   # List of cms programs
   validates :cms_program, inclusion: %w[HQR_PI HQR_IQR HQR_PI_IQR HQR_IQR_VOL HQR_OQR HQR_REHQR
                                         MCP_STANDARD MCP_FQHC
+                                        ASM_INDIV ASM_GROUP LEAD_APM_ENTITY
                                         APP_PLUS_INDIV APP_PLUS_GROUP APP_PLUS_APMENTITY
                                         CPCPLUS PCF MIPS_INDIV MIPS_GROUP MIPS_VIRTUALGROUP MIPS_APMENTITY
                                         MIPS_APP1_INDIV MIPS_APP1_GROUP MIPS_SUBGROUP MIPS_APP1_APMENTITY HL7_Cat_I HL7_Cat_III]

app/views/products/report/_cvu_plus_report.html.erb

@@ -55,7 +55,7 @@
       </tr>
     </thead>
     <tbody>
-      <% %w[HQR_PI HQR_IQR HQR_PI_IQR HQR_IQR_VOL HQR_OQR HQR_REHQR MIPS_GROUP MIPS_INDIV MIPS_VIRTUALGROUP MIPS_APMENTITY MIPS_APP1_INDIV MIPS_APP1_GROUP MIPS_SUBGROUP MIPS_APP1_APMENTITY CPCPLUS PCF MCP_STANDARD MCP_FQHC APP_PLUS_INDIV APP_PLUS_GROUP APP_PLUS_APMENTITY].each do |test| %>
+      <% %w[HQR_PI HQR_IQR HQR_PI_IQR HQR_IQR_VOL HQR_OQR HQR_REHQR MIPS_GROUP MIPS_INDIV MIPS_VIRTUALGROUP MIPS_APMENTITY MIPS_APP1_INDIV MIPS_APP1_GROUP MIPS_SUBGROUP MIPS_APP1_APMENTITY CPCPLUS PCF MCP_STANDARD MCP_FQHC APP_PLUS_INDIV APP_PLUS_GROUP APP_PLUS_APMENTITY ASM_INDIV ASM_GROUP LEAD_APM_ENTITY].each do |test| %>
           <tr>
               <% ptest = @product.product_tests.cms_program_tests.where(cms_program: test ) %>
               <% next if ptest.empty? %>

config/cms_ig.yml

@@ -66,6 +66,21 @@ CMS Programs:
       - APP_PLUS_INDIV
       - APP_PLUS_GROUP
       - APP_PLUS_APMENTITY
+    '2026':
+      - MIPS_GROUP
+      - MIPS_INDIV
+      - MIPS_VIRTUALGROUP
+      - MIPS_APMENTITY
+      - MIPS_APP1_INDIV
+      - MIPS_APP1_GROUP
+      - MIPS_APP1_APMENTITY
+      - MIPS_SUBGROUP
+      - APP_PLUS_INDIV
+      - APP_PLUS_GROUP
+      - APP_PLUS_APMENTITY
+      - ASM_INDIV
+      - ASM_GROUP
+      - LEAD_APM_ENTITY
   eh:
     '2020':
       - HQR_PI
@@ -136,7 +151,7 @@ Program Criterion:
     description:
       eh: 'The organizations Facility CMS Certification Number (CCN). CCN is required for HQR.'
     conf:
-      eh: '(CONF:4444-28241_C01)'
+      eh: '(CONF:4509-28241_C01)'
     programs:
       - HQR_PI
       - HQR_IQR
@@ -156,7 +171,7 @@ Program Criterion:
     description:
       eh: 'Medicare HIC Number is not required for HQR but should be submitted if the payer is Medicare and the patient has an HIC number assigned.'
     conf:
-      eh: '(CONF:4444- 16857_C01)'
+      eh: '(CONF:4509- 16857_C01)'
     programs:
       - HQR_PI
       - HQR_IQR
@@ -189,7 +204,7 @@ Program Criterion:
     description:
       eh: 'Medicare Beneficiary Identifier (MBI) is not required for HQR but should be submitted if the payer is Medicare and the patient has an MBI number assigned.'
     conf:
-      eh: '(CONF:4444- 28697_C01)'
+      eh: '(CONF:4509- 28697_C01)'
     programs:
       - HQR_PI
       - HQR_IQR
@@ -199,24 +214,18 @@ Program Criterion:
       - HQR_REHQR
   CMS EHR Certification ID:
     name: 'CMS EHR Certification ID'
-    optional:
-      - MIPS_GROUP
-      - MIPS_INDIV
-      - MIPS_VIRTUALGROUP
-      - MIPS_APMENTITY
-      - MIPS_APP1_INDIV
-      - MIPS_APP1_GROUP
-      - MIPS_APP1_APMENTITY
     description:
       CPCPLUS: 'For CPC+, all QRDA III files must include a CMS EHR Certification ID. Nulls will not be allowed.'
       PCF: 'For PCF, all QRDA III files must include a CMS EHR Certification ID. Nulls will not be allowed.'
-      MIPS_GROUP: 'CMS EHR Certification ID is optional for the MIPS Quality performance category.'
-      MIPS_INDIV: 'CMS EHR Certification ID is optional for the MIPS Quality performance category.'
-      MIPS_VIRTUALGROUP: 'CMS EHR Certification ID is optional for the MIPS Quality performance category.'
-      MIPS_APMENTITY: 'CMS EHR Certification ID is optional for the MIPS Quality performance category.'
-      MIPS_APP1_INDIV: 'CMS EHR Certification ID is optional for the MIPS Quality performance category.'
-      MIPS_APP1_GROUP: 'CMS EHR Certification ID is optional for the MIPS Quality performance category.'
-      MIPS_APP1_APMENTITY: 'CMS EHR Certification ID is optional for the MIPS Quality performance category.'
+      MIPS_GROUP: 'For MIPS and ASM submissions, CMS EHR Certification ID is required for the Quality performance category.'
+      MIPS_INDIV: 'For MIPS and ASM submissions, CMS EHR Certification ID is required for the Quality performance category.'
+      MIPS_VIRTUALGROUP: 'For MIPS and ASM submissions, CMS EHR Certification ID is required for the Quality performance category.'
+      MIPS_APMENTITY: 'For MIPS and ASM submissions, CMS EHR Certification ID is required for the Quality performance category.'
+      MIPS_APP1_INDIV: 'For MIPS and ASM submissions, CMS EHR Certification ID is required for the Quality performance category.'
+      MIPS_APP1_GROUP: 'For MIPS and ASM submissions, CMS EHR Certification ID is required for the Quality performance category.'
+      MIPS_APP1_APMENTITY: 'For MIPS and ASM submissions, CMS EHR Certification ID is required for the Quality performance category.'
+      ASM_INDIV: 'For MIPS and ASM submissions, CMS EHR Certification ID is required for the Quality performance category.'
+      ASM_GROUP: 'For MIPS and ASM submissions, CMS EHR Certification ID is required for the Quality performance category.'
       eh: 'The Certified Health Information Technology (IT) Product List (CHPL) is the authoritative and comprehensive listing of health IT certified through the Office of the National Coordinator for Health Information Technology (ONC) Health IT Certification Program. A CMS EHR Certification Identification Number is a number generated by the CHPL and used for reporting to CMS.'
     conf:
       eh: '(CONF:CMS_0005)'
@@ -239,16 +248,31 @@ Program Criterion:
       - MIPS_APP1_APMENTITY
       - MCP_STANDARD
       - MCP_FQHC
+      - ASM_INDIV
+      - ASM_GROUP
   TIN:
     name: 'Tax Identification Number'
+    optional:
+      - HQR_PI
+      - HQR_IQR
+      - HQR_PI_IQR
+      - HQR_IQR_VOL
+      - HQR_OQR
+      - HQR_REHQR
     description:
       CPCPLUS: 'For CPC+: it must contain at least one performer, each performer contains one TIN and one NPI'
       PCF: 'For PCF: it must contain at least one performer, each performer contains one TIN and one NPI'
       MIPS_GROUP: 'For MIPS group reporting: it must contain exactly one performer, which contains one TIN. No NPI is allowed.'
       MIPS_INDIV: 'For MIPS individual reporting: it must contain exactly one performer, which contains one TIN and one NPI.'
+      MIPS_APP1_INDIV: 'Required for APP group reporting and APP individual reporting'
+      MIPS_APP1_GROUP: 'Required for APP group reporting and APP individual reporting'
+      APP_PLUS_INDIV: 'Required for APP Plus group reporting and APP Plus individual reporting'
+      APP_PLUS_GROUP: 'Required for APP Plus group reporting and APP Plus individual reporting'
+      ASM_INDIV: 'Required for ASM individual and group reporting'
+      ASM_GROUP: 'Required for ASM individual and group reporting'
       eh: 'For HQR, TIN may not be applicable. If TIN is submitted for HQR, then it SHALL conform to the constraints specified for TIN. and the TIN must be in valid format (9 decimal digits).'
     conf:
-      eh: '(CONF:4444-16593)'
+      eh: '(CMS_0119)'
       ep: '(CONF:3338-18190)'
     programs:
       - HQR_PI
@@ -267,6 +291,8 @@ Program Criterion:
       - MCP_FQHC
       - APP_PLUS_INDIV
       - APP_PLUS_GROUP
+      - ASM_INDIV
+      - ASM_GROUP
   Virtual Group Identifier:
     name: 'Virtual Group Identifier'
     description:
@@ -277,15 +303,26 @@ Program Criterion:
       - MIPS_VIRTUALGROUP
   NPI:
     name: 'National Provider Identification number'
+    optional:
+      - HQR_PI
+      - HQR_IQR
+      - HQR_PI_IQR
+      - HQR_IQR_VOL
+      - HQR_OQR
+      - HQR_REHQR
     description:
       CPCPLUS: 'For CPC+: it must contain at least one performer, each performer contains one TIN and one NPI'
       PCF: 'For PCF: it must contain at least one performer, each performer contains one TIN and one NPI'
       MIPS_INDIV: 'For MIPS individual reporting: it must contain exactly one performer, which contains one TIN and one NPI.'
+      MIPS_APP1_INDIV: 'Required for APP individual reporting'
+      APP_PLUS_INDIV: 'Required for APP Plus individual reporting'
+      ASM_INDIV: 'Required for ASM individual and group reporting'
+      ASM_GROUP: 'Required for ASM individual and group reporting'
       eh: 'For HQR, NPI may not be applicable. If NPI is submitted for HQR, then the NPI SHALL conform to the constraints specified for NPI and the NPI must be in the correct format.'
       ep:
     conf:
-      eh: '(CONF:3364-28497)'
-      ep: '(CONF:3338-18247)'
+      eh: '(CMS_0115)'
+      ep: '(CONF:5562-18247)'
     programs:
       - HQR_PI
       - HQR_IQR
@@ -299,6 +336,8 @@ Program Criterion:
       - PCF
       - MCP_STANDARD
       - APP_PLUS_INDIV
+      - ASM_INDIV
+      - ASM_GROUP
   CPCPLUS APM Entity Identifier:
     name: 'CPCPLUS APM Entity Identifier'
     description:
@@ -325,15 +364,16 @@ Program Criterion:
       - MCP_STANDARD
       - MCP_FQHC
   MIPS APM Entity Identifier:
-    name: 'MIPS APM Entity Identifier'
+    name: 'APM Entity Identifier'
     description:
-      ep: 'This is the MIPS APM Entity Identifier assigned to the MIPS practice site.'
+      ep: 'This is the APM Entity Identifier assigned to the practice site.'
     conf:
       ep: '(CONF:CMS_109)'
     programs:
       - MIPS_APMENTITY
       - MIPS_APP1_APMENTITY
       - APP_PLUS_APMENTITY
+      - LEAD_APM_ENTITY
   MIPS Subgroup Identifier:
     name: 'MIPS Subgroup Identifier'
     description:
@@ -379,3 +419,15 @@ requirement.'
       - MIPS_APP1_INDIV
       - MIPS_APP1_GROUP
       - MIPS_APP1_APMENTITY
+  ASM Cohort:
+    name: 'ASM Cohort'
+    description:
+      ep: 'Each ASM participant is assigned to a specific cohort.'
+    conf:
+      ep: '(CONF:CMS_160)'
+    programs:
+      - ASM_INDIV
+      - ASM_GROUP
+    optional:
+      - ASM_INDIV
+      - ASM_GROUP

config/cypress.yml

@@ -480,7 +480,6 @@ version_config:
           code: "854901"
           codeSystem: "2.16.840.1.113883.6.88"
       CMSQRDA3SchematronValidator_warnings:
-        - "The 2027 CMS EC QRDA Category III submission rules haven't been finalized yet"
       CMSQRDA1HQRSchematronValidator_warnings:
 
 # Configuration for values to use when randomizing patients in test decks

lib/cypress/api_measure_evaluator.rb

@@ -609,7 +609,7 @@ def calcuate_cat3(product_test_id, bundle_id)
                                 end
       options = { provider: pt.patients.first.providers.first, submission_program: cat3_submission_program,
                   start_time: pt.start_date, end_time: pt.end_date, ry2025_submission: pt.bundle.major_version == '2024',
-                  ry2026_submission: pt.bundle.major_version == '2025' }
+                  ry2026_submission: pt.bundle.major_version == '2025', ry2027_submission: pt.bundle.major_version == '2026' }
       # To pass C3 tests, all populations and supplemental codes need to be reported
       xml = Qrda3.new(cloned_pt.send(:expected_results_with_all_supplemental_codes), pt.measures, options).render
 

lib/validators/program_criteria_validator.rb

@@ -110,6 +110,7 @@ def find_entered_value(entered_value, checked_criteria)
         'PCF APM Entity Identifier' => "//cda:participant/cda:associatedEntity/cda:id[@extension='#{entered_value}' and @root='2.16.840.1.113883.3.249.5.3']",
         'MVP Code' => "//cda:participant[@typeCode='TRC']/cda:associatedEntity[@classCode='PROG']/cda:id[@extension='#{entered_value}' and @root='2.16.840.1.113883.3.249.5.6']",
         'SSP PI Reporting' => "//cda:participant[@typeCode='IND']/cda:associatedEntity[@classCode='PROG']/cda:id[@extension='#{entered_value}' and @root='2.16.840.1.113883.3.249.5.7']",
+        'ASM Cohort' => "//cda:participant[@typeCode='IND']/cda:associatedEntity[@classCode='PROG']/cda:id[@extension='#{entered_value}' and @root='2.16.840.1.113883.3.249.5.8']",
         'MIPS APM Entity Identifier' => "//cda:documentationOf/cda:serviceEvent/cda:performer/cda:assignedEntity/cda:representedOrganization/cda:id[@extension='#{entered_value}' and @root='2.16.840.1.113883.3.249.5.4']",
         'MCP APM Entity Identifier' => "//cda:documentationOf/cda:serviceEvent/cda:performer/cda:assignedEntity/cda:representedOrganization/cda:id[@extension='#{entered_value}' and @root='2.16.840.1.113883.3.249.5.4']",
         'MIPS Subgroup Identifier' => "//cda:documentationOf/cda:serviceEvent/cda:performer/cda:assignedEntity/cda:representedOrganization/cda:id[@extension='#{entered_value}' and @root='2.16.840.1.113883.3.249.5.5']",