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CMS opens public comment on FHIR-based digital quality measures, publishes measure packages and test decks

Centers for Medicare & Medicaid Services (CMS) Digital Quality Measure (DQM) Public Comment Webinar · January 30, 2026

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Summary

CMS opened a public comment period and published FHIR-based digital quality measure (DQM) packages and four test decks via the Maddy export system, asking stakeholders to review artifacts on ONC JIRA and provide feedback by Feb. 23, 2026.

CMS hosted a public comment webinar on Jan. 21, 2026, to introduce its transition from electronic clinical quality measures (eCQMs) to FHIR‑based digital quality measures (DQMs) and to publish measure packages and test case exports for stakeholder review. Joel Andres, identified in the webinar as CMS’s Digital Quality Measurement Lead, said the initiative aims to reduce provider reporting burden and improve data interoperability.

CMS explained the materials will be posted in ONC JIRA tickets where measure specifications and test decks can be reviewed and commented on by measure stewards and developers. "We've asked you to join us to take a forward looking view of the future of quality reporting across CMS's programs," Joel Andres said during the presentation.

The agency described multiple export formats available for each measure package: HTML (human readable), JSON and XML (machine readable), and a CQL folder containing the clinical quality language logic and supporting libraries. CMS said the Maddy tool (described in the webinar as a second‑generation authoring, testing, and publication system) produces these exports to help measure developers and implementers test and adopt the measures.

CMS is also providing four pilot FHIR test decks to demonstrate test case exports and to solicit feedback on presentation and usability. Joel Andres said the test decks include per‑case JSON files and an index mapping UUIDs to test case titles, and that measure developers create synthetic patient records to validate measure logic and achieve the intended pass/fail coverage.

The DQM packages published for public comment include 17 hospital inpatient measures, four hospital outpatient measures, and 49 eligible clinician measures; some measures have accompanying test case exports. Public comments are open from 01/21/2026 through 02/23/2026 and should be submitted directly on the corresponding ONC JIRA tickets listed in the webinar materials.

CMS asked reviewers to consult the posted "guide for reading DQM test cases" and the targeted questions document to focus feedback on measure intent, technical specifications, and implementation clarity. The agency said measure stewards and developers will review comments after the public comment period and respond where appropriate.

Next steps: stakeholders can access measure packages and test decks via the ONC JIRA links provided with the webinar slides and submit comments on the individual measure tickets before the Feb. 23, 2026 deadline.