In the 2016 CMS QRDA Combined SIG (i.e. "CMS Implementation Guide for Quality Reporting Document Architecture Category I and Category III, Eligible Professional Programs and Hospital Quality Reporting (HQR), Supplementary Implementation Guide for 2016, Version: 1.0 07/08/2015") there is this constraint:

i. The assignedPerson, if present, MAY contain zero or one [0..1] name (CONF:CMS_0020).

In the 2016 Base QRDA-1 HL7 IG (i.e. "HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture Category I (QRDA I); Release 1, DSTU Release 3 - US Realm, Draft Standard for Trial Use, Volume 2 - Templates and Supporting Material, June 2015") there is this constraint:

1. SHALL contain exactly one [1..1] name (CONF:81-9368).

These two constraints don't conflict because CMS_0020 is associated with the 'name' element at this xPath:

/ClinicalDocument/documentationOf/serviceEvent/performer/assignedEntity/assignedPerson/name

And 81-9368 is only associated with a specific 'name' element under template ID 2.16.840.1.113883.10.20.22.5.1.1.

However, when a test file was submitted with two CMS_0020 'name' elements, the ESAC Schematron rules generated a CONF:81-9368 violation.

I examined the rules file and discovered that the 'context' for the 81-9368 assertions is incorrect. It makes no mentioned of template ID 2.16.840.1.113883.10.20.22.5.1.1. Here is the 'context' for the assertion:

<sch:rule id="r-urn-oid-2.16.840.1.113883.10.20.22.5.1.1-errors" context="//*[cda:name[parent::cda:patient or parent::cda:guardianPerson or parent::cda:assignedPerson or parent::cda:informationRecipient]]">