In its current publication, CMS50 utilizes the relationship operator 'fulfills' in order to express a condition that the consultant report received from one provider to another provider (using the QDM Category/Datatype 'Communication: From Provider to Provider') would fulfill the referral criteria from the Initial Population. The current logic expression is as follows:

AND: "Communication: From Provider to Provider: Consultant Report" satisfies all:

• fulfills "Occurrence A of Intervention, Performed: Referral"
• starts after start of "Occurrence A of Intervention, Performed: Referral"

When converting this measure to CQL expression logic, we were informed that there currently is no equivalent expression that we can use to translate the measure specification. As this measure is part of the QPP's EHR measures which can be reported, we are hoping to have a way to express this in the near future.