Please verify the following: if the initial population for Vital Signs is less than 90% (majority are the Surgical patients that will be excluded) the hospital faces potential reduction in receiving a full Medicare Annual Payment Update (APU) under the Hospital IQR Program. The other linking variables and lab results have been met. 

Specifically, hospitals should populate the QRDA 1 files based on the IPP definitions. Importantly, CMS evaluates the data submission requirements based on the IPP, not on the final measure cohort (the population after inclusion/exclusion criteria are applied).