We are writing this ticket to get more clarification on CQM-6600 for CMS-50 and other measures in general.

The response on CQM-6600 suggests that the referral is clinician-specific. That is if the patient has two referrals with two different clinicians, which referral to check in the numerator logic will depend on which clinician the patient is evaluated against.

We understand this may be the measure intent, but could you clarify which part of the measure CQL logic or the Implementation Guide specifies this? 

Our interpretation on patient-based measures is that we should consider all data for this patient. This is vaguely mentioned in "eCQM and Implementation Guidance v7.0" Section 1.2.1: The criteria for inclusion of a patient in a measure population might
require satisfying conditions across multiple patient encounters, or episodes of care.

The inclusion of all data points also implies that a patient's outcome for a patient-based measure should be the same regardless of which clinician/group we are evaluating, where the outcome represents the quality of care received by the patient as a whole.

If a measure is looking for a diagnosis, do we only look at the diagnosis each EC makes for a single patient?

CQM-6600 makes it seem like CMS-50 should have been written as an episode-based measure.