Brief description of measure CMS646: Intravesical Bacillus-Calmette-Guerin for non-muscle invasive bladder cancer: Percentage of patients initially diagnosed with non-muscle invasive bladder cancer and who received intravesical Bacillus-Calmette-Guerin (BCG) within 6 months of bladder cancer staging. Description of issue The measure currently allows a 6 month timeframe for the administration of Bacillus-Calmette-Guerin from the start of the bladder cancer staging procedure, where the bladder cancer staging procedure is tied to the measurement period. The specification does not currently allow all clinicians the full 6 months to administer the BCG should a patient's staging procedure occur within the last 6 months of the measurement period. The measure developer proposes revising the logic by shifting the timing of the first bladder cancer staging to the latter 6 months of the year prior to the measurement period through the first 6 months of the measurement period. This would provide all clinicians the same amount of time to complete the numerator action while continuing to collect data through the end of the measurement period. Goal of review Obtain clinical and technical feedback

Proposed solution ​​Change the timing and the logic to anchor all data into the measurement period or the prior year. CURRENT LOGIC: define "First Bladder Cancer Staging Procedure during Measurement Period" "First Bladder Cancer Staging Procedure" FirstBladderCancerStaging   where Global."NormalizeInterval" ( FirstBladderCancerStaging.relevantDatetime, FirstBladderCancerStaging.relevantPeriod ) during "Measurement Period" PROPOSED LOGIC: define "First Bladder Cancer Staging Procedure during Measurement Period"      "First Bladder Cancer Staging Procedure" FirstBladderCancerStaging         where Global."NormalizeInterval" ( FirstBladderCancerStaging.relevantDatetime, FirstBladderCancerStaging.relevantPeriod ) during day of Interval ["July 1 of Year Prior to the Measurement Period," "June 30 of the Measurement Period"] define "July 1 of Year Prior to the Measurement Period"     DateTime((year from start of "Measurement Period" - 1), 7, 1, 0, 0, 0, 0, 0) define "June 30 of the Measurement Period"     DateTime((year from start of "Measurement Period"), 6, 30, 23, 59, 59, 0, 0)  Rationale for change Anchoring the timing of the first bladder cancer staging procedure through the end of the measurement period will align with CMS' preference to not collect data after the end of a performance period and still align with the measure intent.