An additional step is being taken by the Centers for Medicare and Medicaid Services to pave the way for hospitals to transmit clinical quality measures to the agency via electronic health records systems. The intent of CMS is to start a voluntary testing program to submit via EHRs certain standardized data elements for the Reporting Hospital Quality Data for Annual Payment Update program, known as RHQDAPU. The proposed rule regarding the same was published in May to establish the 2010 hospital inpatient Medicare prospective payment system. The elements would cover stroke, venous thromboembolism and emergency department throughput. Now, the agency is seeking public comment on voluntary testing with up to 55 facilities, with comments due by Oct. 27. The data measures collected via EHRs would not substitute for submission of data elements required under RHQDAPU under current processes. Hospitals are mandated to report certain quality measures under RHQDAPU, which was authorized under the Medicare prescription drug law in 2003. Hospitals that do not report receive lower Medicare payments. In 2010, 42 measures are reportable.