Thank you for your questions on Safe Use of Opioids (CMS 506). 1. A. Only patients with active cancer should be excluded from the measure. The measure uses the terms "prior to" and "during" to indicate that the active cancer can be diagnosed before the relevant inpatient stay or during it as long as the cancer is active at the time the patient is discharged from their inpatient stay. The value set "All Primary and Secondary Cancer" (2.16.840.1.113762.1.4.1111.161) should be used to identify which cancer diagnoses should exclude a patient from the measure. B. While the cancer diagnosis will likely be on the Active Problem list, it does not need to be the reason for inpatient admission to exclude a patient from the Safe Use measure. C. Patients do not need to be undergoing treatment for cancer to be excluded, they only need an active cancer diagnosis. 2 A. Patients discharged against medical advice are currently included in the measure. We are considering incorporating these patients into the denominator exclusion for future versions of the measure. B. An inpatient encounter is identified by the value set "Encounter Inpatient" (2.16.840.1.113883.3.666.5.307). If an inpatient encounter identified through this value set ends when a patient is transferred to rehab, than it would be the equivalent of the patient being discharged from their inpatient stay.