In the 2021 Hybrid HWR specification, the Supplemental Data Elements section shows the following and does not display the 4 supplemental elements collected for all of the other eCQMs - Ethnicity, Race, Payer, Sex.

1. We know that Data Element Sex is one of the linking variables so it is understood that we need to include it in the QRDA file.
2. There is no reference to Race and Ethnicity. So are we to not include that in the QRDA file submission to CMS with the hybrid measure? Can you please confirm?
3. Payer - The QDM element defined is "Participation" NOT "Payer".

In the QRDA spec, Participation and Payer are 2 different QDM elements. Since "Participation" is defined in the data criteria, it is understood we need to include that in the QRDA file. But the QDM "Payer" is NOT defined. So are we expected to NOT include it in the file? Can you please confirm?

We typically include the QDM elements based on what is included in the specification in the the Data criteria and Supplemental elements section. Since Race, Ethnicity and Payer are not defined, it seems we would not be expected to include them in the file, but we would appreciate if you could confirm for us? If the answer is that we need to include them, will CMS issue an updated specification with these data elements included in the Supplemental Data Section?

Thanks in advance for your review and feedback.