For EH measures, the reporting requirements are specified in the CMS QRDA-I implementation guide for EH. This is downloadable from QualityNet website,
https://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier3&cid=1228772217179 “CMS Hospital Reporting (HR) Quality Reporting Document Architecture (QRDA) Category I Release 2 Supplementary Implementation Guide - 2014 data submission, PDF-527 KB (11/12/13)”. Per the CMS QRDA-I implementation guide for EH, nullFlavor is not allowed for race, ethnicity, and gender. For example, if a patient race is not recorded in an EHR because patient has declined to provide the information, QRDA-I report for this patient will be rejected. This requirement will stay as it is until the next release of the CMS QRDA-I implementation guide for EH will be published, which is likely in the July, 2014 time frame.
For EP measures, the reporting requirements are specified in the 2014 CMS QRDA-I implementation guide for EP programs, which is available at the CMS site
http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/ClinicalQualityMeasures.html. Per the CMS QRDA-I implementation guide for EP, nullFlavor is allowed for race, ethnicity, and gender (note, this differs from the current EH reporting requirements). For example, if a patient race is not recorded in an EHR because patient has declined to provide the information, a nullFlavor should be sent for /ClinicalDocument/recordTarget/patientRole/patient/raceCode.
An update to the CMS QRDA-I implementation guide for hospital quality reporting (for EH measures):
The draft CMS HQR Supplementary Implementation Guide (Version 2.2, 02/07/2014) is now available for public comment, which can be downloaded at
http://jira.oncprojectracking.org/browse/HQRIG-1. In this new draft version, nullFlavor is now allowed for race, ethnicity, and gender. If you have any feedback or comments regarding this draft HQR guide, please submit new JIRA tickets under the "CMS HQR Supplementary Implementation Guide" project.