As written, the logic in CMS117v10 does not include Hepatitis B Vaccines administered on the Date of Birth.

This steams from an inconsistency in the CQL specification (https://jira.hl7.org/browse/FHIR-35869). In one reference the ToDateTime conversion results is a DateTime with a precision of Day (This has been confirmed as the correct behavior). In the other reference, the ToDateTime conversation results in a DateTime with with a precision of Second.

Currently, the cql-execution library (used by Bonnie) follows the second reference using the (incorrect) precision of Second which is why this was not caught during eCQM reviews.

As written, the logic in CMS117 will not include any Hepatitis B Vaccines given on the date of birth. This could impact the Numerator calculations for the majority of patients.

The logic in CMS117 needs to be rewritten using the 'day of' modifier to fix this issue. The modified logic is below.

Current logic

where HepatitisBVaccination.relevantDatetime during "First Two Years"

Updated logic

where HepatitisBVaccination.relevantDatetime during day of "First Two Years"