Brief description of measure CMS136: Follow-Up Care for Children Prescribed ADHD Medication (ADD):  Percentage of children 6-12 years of age and newly prescribed a medication for attention-deficit/hyperactivity disorder (ADHD) who had appropriate follow-up care. Two rates are reported.     a. Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase.   b. Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended. Description of issue ​For Numerator 2, the measure header and logic currently do not require two follow up visits to be on different dates of service to meet criteria. Currently, if two follow up visits occur on same day, this would meet the measure criteria. This does not align with the measure intent, therefore, the Measure Developer would like add the requirement that two follow up visits be on different dates of service. Goal of review Obtain technical feedback

Proposed solution //Header - before Numerator 2: Patients who had …, and at least two follow-up visits during the 31-300 days after the IPSD. //Header - after Numerator 2: Patients who had …, and at least two follow-up visits on different dates of service during the 31-300 days after the IPSD. //Logic - before define "Numerator 2":   exists ...     and ( ( "Two or More Encounters 31 to 300 Days into Continuation and Maintenance Phase" )         or ( exists ( "Encounter 31 to 300 Days into Continuation and Maintenance Phase" )             and exists ( "Online Assessment 31 to 300 Days into Continuation and Maintenance Phase" )        )    ) define "Two or More Encounters 31 to 300 Days into Continuation and Maintenance Phase":   Count("Encounter 31 to 300 Days into Continuation and Maintenance Phase")>= 2 define "Encounter 31 to 300 Days into Continuation and Maintenance Phase":   "Qualifying Numerator Encounter" ValidNumeratorEncounter     with "First ADHD Medication Prescribed During Intake Period" InitialADHDMedication       such that ... define "Online Assessment 31 to 300 Days into Continuation and Maintenance Phase":   ["Encounter, Performed": "Online Assessments"] OnlineAssessment     with "First ADHD Medication Prescribed During Intake Period" InitialADHDMedication       such that ... //Logic - after define "Numerator 2":   exists ( "Encounter During Initiation Phase" )     and ( ( "Two or More Encounters 31 to 300 Days into Continuation and Maintenance Phase" )         or ( exists ( "Encounter 31 to 300 Days into Continuation and Maintenance Phase" Encounter1               with "Online Assessment 31 to 300 Days into Continuation and Maintenance Phase" Encounter2                 such that Encounter1 is not null                   and Encounter2 is not null                   and Encounter1 !~ Encounter2          )        )    ) define "Two or More Encounters 31 to 300 Days into Continuation and Maintenance Phase":   Count("Encounter 31 to 300 Days into Continuation and Maintenance Phase")>= 2 define "Encounter 31 to 300 Days into Continuation and Maintenance Phase":   "Qualifying Numerator Encounter" ValidNumeratorEncounter     with "First ADHD Medication Prescribed During Intake Period" InitialADHDMedication       such that ...     return date from start of ValidNumeratorEncounter.relevantPeriod define "Online Assessment 31 to 300 Days into Continuation and Maintenance Phase":   ["Encounter, Performed": "Online Assessments"] OnlineAssessment     with "First ADHD Medication Prescribed During Intake Period" InitialADHDMedication       such that ...     return date from start of OnlineAssessment.relevantPeriod Rationale for change ​This change is made to align with the measure intent and approach in the HEDIS parent measure.