Brief description of measure CMS74: Primary Caries Prevention Intervention as Offered by Dentists: Percentage of children, 6 months - 20 years of age, who received a fluoride varnish application during the measurement period as determined by a dentist. CMS75: Children Who Have Dental Decay or Cavities: Percentage of children, 6 months - 20 years of age at the start of the measurement period, who have had tooth decay or cavities during the measurement period as determined by a dentist. Description of issue In order to align with existing dental measures, such as those in the Medicaid Child Core set, the age criteria in CMS74 and CMS75 will be updated to begin at 1 year of age and end at 20 years of age. The age stratifications in CMS74 will also be updated accordingly. Goal of review Obtain clinical feedback

Proposed solution ​//CMS74, 75 Header before Description: Percentage of children, 6 months - 20 years of age... Initial Population: Children, 6 months - 20 years of age... //CMS74, 75 Header after Description: Percentage of children, 1-20 years of age... Initial Population: Children, 1-20 years of age... //CMS74, 75 Logic before define "Initial Population":   AgeInMonthsAt(date from start of "Measurement Period")>= 6     and AgeInYearsAt(date from start of "Measurement Period")<= 20 ... //CMS74, 75 Logic after define "Initial Population":   AgeInYearsAt(date from start of "Measurement Period") in Interval[1, 20] ... //CMS75 stratifications before Stratification: Population 1: Patients age 6 months - 5 years... define "Stratification 1":   AgeInMonthsAt(date from start of "Measurement Period")>= 6     and AgeInYearsAt(date from start of "Measurement Period")<= 5 //CMS75 stratifications after Stratification: Population 1: Patients age 1-5 years... define "Stratification 1":   AgeInYearsAt(date from start of "Measurement Period") in Interval[1, 5] Rationale for change This change would align the measure with the Medicaid Child Core Set dental measures and Dental Quality Alliance (DQA) measures. For example, the Topical Fluoride for Children Measure in the Medicaid Child Core Set specifies “Percentage of enrolled children ages 1 through 20 who received at least two topical fluoride applications as: (1) dental or oral health services, (2) dental services, and (3) oral health services within the measurement year.”   The Guidelines and recommendations for preventative dental services vary considerably by source. There is agreement that fluoride varnish application should begin at the age of primary tooth eruption. That tends to occur around 1 year of age, and there is very little concern that individuals between the age of 6 months and 1 year would be lost. This change is made in an effort to align measure across programs, while staying consistent with the evidence and guidelines.   The measure developer solicited input from the Dental Expert Work Group (EWG), which supports the current age range but acknowledges the importance of aligning with existing dental measures.