Thank you for your feedback on the Statin Therapy for the Prevention and Treatment of Cardiovascular Disease eCQM. We will evaluate clarifications to the specification’s Guidance section during the next Annual Update cycle. To correct your interpretation, it is not the “the highest ASCVD risk score in the measurement period” for population #4, but rather that the 10-year CVD risk High exists = Yes if any score is equal to or greater than 20%. For example, if a patient had a 20, 19, and 22% during the measurement period, the logic would say “yes” because at least one score was 20% or greater. We understand the concerns about implementation consistency. The CQL logic, as currently written, will assess any result >/= 20% during the measurement period. Without a logical representation of ordinality or highest, etc., the default is “any” in the measurement period. v.8 Specification excerpt: Ten Year CVD Risk is High • o ( exists ( ["Assessment, Performed": "Cardiovascular disease 10Y risk [Likelihood]"] o union ["Assessment, Performed": "Cardiovascular disease 10Y risk [Likelihood] ACC-AHA Pooled Cohort by Goff 2013"] ) AtRiskCVD o where AtRiskCVD.result as Quantity >= 20 '%' o and Global."NormalizeInterval" ( AtRiskCVD.relevantDatetime, AtRiskCVD.relevantPeriod ) during day of "Measurement Period" o )

Due to the guidance section of Statin Therapy CMS347v8 not explicitly stating if the highest ASCVD risk score during the measurement period should be used to determine the eligibility of population 4, the total eligible population for the Statin Therapy CMS347 eCQM may vary between vendors and organizations.