CMS EQRS Data Submissions

CMS is opening the EQRS database for clinical months September, October, November and December 2020 for EQRS Clinical Data, ICH CAHPS Attestation, and Clinical Depression Screening and Follow-up Plan data submissions. Please review the items below to prepare for this data submission process, and share with others in your organizations and your EHR vendor. 

The EQRS database will be opened for all data submissions starting Monday, July 12, 2021 and closing on Wednesday, September 1, 2021 at 11:59 p.m. Pacific Daylight time.

The EQRS database will only be accepting data for the clinical months September – December 2020. Any data you had previously submitted before CMS closed EQRS to new clinical data should still be in the EQRS database. If you find that any of your data is missing, please submit a Renal Healthcare HIE Support form.

Thank you in advance for your consideration and planning for this clinical data submission re-opening for EQRS. We will notify you when we receive any updates from CMS regarding this 2020 data submission process.

EQRS Data Error Codes Table

CMS has released the updated EQRS data error codes list for use by your organization and your vendor. This list provides the error codes currently in use by the EQRS database when processing submitted data.

Tips for 2020 EQRS Data Submissions

Review the tips below to prepare for and process 2020 EQRS data submissions.

Prepare for the 2020 Clinical Month Data Submissions

To be ready to submit your 2020 data within this compressed timeline, work with your data submission teams and vendor support teams to ensure your 2020 EQRS Clinical Data is current in your systems and that Patient Demographic data is up-to-date in EQRS. This will help reduce the potential for submission errors that could impact data submission completion.

2020 Data Submission Process

Plan to submit the 2020 data in month order from where you left off when CMS shut down the EQRS database for the clinical submissions in January of 2021.

For example, if you hadn’t completed data submissions for September 2020 start by submitting the September 2020 patient demographic files first, working and resolving any errors, then submit the September 2020 clinical data, working and resolving any errors until that month’s submissions are complete. Then quickly move on to working the October submissions in the same way and repeat the same processes for November and December.

Transient Patients

One of the important changes to be aware of in the EQRS system is the elimination of the Transient patient data submission requirements. Work with your data submission and vendor teams to remove any EQRS data files that you may try to send in for a Transient patient.

If you submit data files that are marked as "transient," the data will be rejected for that patient. You are now only required to report on your permanent admitted patients.


NRAANaks are new error notifications that are coming from the EQRS system. The NRAANaks are generated by the EQRS system when the EQRS file submitted is not formatted correctly or the data contained in the file does not meet format requirements. Please know the following about the NRAANaks:

a. When a submitted EQRS file receives a NRAANak, it is not processed by the EQRS database and will NOT receive a Deferred Response.

b. NRAANaks are delivered to the Prod_In directory on the Activator connectivity software or to a special sub-directory under the Prod_In directory called NRAANak.

c. Customers will also receive an email notification when they receive a NRAANak for any file. Note, the email notification does not contain the actual error information. This information will need to be obtained from the actual NRAANak.

d. NRAANaks contain specific information from the EQRS system about where the file failed format conformance. This information can be used to resolve the file errors.

e. When the file errors are resolved and a corrected file is submitted, the EQRS system will send a NRAAAck (to confirm the file was successfully received) and then process the file. A Deferred Response will then be sent to notify the submitter if the processing was successful or failed processing because of a data content error.


Receiving Deferred Responses

Because there will be a significant volume of data submissions being sent to the EQRS database during this compressed time period, please wait 24 hours for your Deferred Responses when submitting your EQRS files.

We expect the system to perform with response times of less than 5 seconds, but we have never seen this level of volume in this compressed time period so please be patient if you are not receiving Deferred Responses as quickly as you typically receive them.

The EQRS system may get significantly bogged down and the Renal Healthcare HIE may need to periodically queue data to feed the volume to the EQRS system at a slower rate to prevent the system from collapsing because of the excess volume.

If you haven't received a NRAANak (that indicates the file failed format conformance and wasn't processed by the EQRS database) or a Deferred Response within 24 hours, then you can resubmit your files for a second attempt at successfully getting the EQRS system to process your files.

Renal Healthcare Support Form

If you need any assistance during this data submission time period, please submit a Renal Healthcare HIE Support form.

DO NOT enter any patient personal identifiable information (PII) or protected health information (PHI) in the support ticket.

This support ticket system IS NOT supported in a secured platform. Therefore, PII and PHI MUST NOT be entered into the support form.

In the support form indicate you have an EQRS data or error question and then describe the issue you are experiencing in the Description of issue box of the form. When the support representative reaches out to you, please follow their instructions for sharing any data necessary to resolve the issue. 

The Renal Healthcare HIE will be monitoring the support forms and also escalating unexpected and abnormal issues directly to CMS leadership. Reporting your concerns is important.


Facility Completion and Missing Clinicals Reports

During the time period for the 2020 clinical submissions, CMS will be resuming the preparation of the Facility Completion and Missing Clinicals reports. The Renal Healthcare HIE team will push out these reports as CMS makes them available so you can monitor your data submission status. We will announce the delivery of these reports as they are distributed. 

Hold 2021 EQRS Data Submissions

Do not submit any 2021 EQRS data during this 2020 clinical month opening. Any 2021 data submitted will be rejected.

Opening of the 2021 EQRS clinical reporting months is TBA. However, expect the process to catch up on 2021 EQRS reporting to be similar to the 2020 data submission process.