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Overview

CL-29-EN-66 computes two NCQA HEDIS substance-use follow-up quality measures — FUA (Follow-Up After ED Visit for Substance Use) and FUI (Follow-Up After High-Intensity SUD Care) — each as a 7-day and a 30-day rate, surfaced as columns on the existing CL measure dashboard. The measures extend the EN-65 FUH/FUM substrate and emit an at-risk cohort to CL-35; they own no outreach and add no new route. This guide covers the two operator-facing controls, both resolved through PF-96 jurisdiction profiles (ComplianceRules), never hardcoded in code:
  • the active Measurement Year toggle (MY2025 ↔ MY2026) and its mid-period integrity guarantee;
  • the FUI high-intensity scope toggle and the external-benchmarkability trade-off it carries.
Architecture and the upstream/downstream contract (PF-108 ADT ingest, CL-51 registration, CL-35 care-gap emit, the DS4P leg, and the T4.3 hardening audit) are in the FUA/FUI integration doc. Regulatory status and the four human-verify-open gates are in the Regulatory Compliance Tracker.

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1. Setting the active Measurement Year (MY2025 ↔ MY2026)

NCQA publishes the FUA/FUI ruleset by Measurement Year. The two versions differ in the denominator and numerator rules: The active version is set per org via the PF-96 ComplianceRules field active_measurement_year_version ('MY2025' or 'MY2026'). The engine reads it at evaluation time — it never infers the year from the system clock — so the rate you see always reflects the configured ruleset, not the calendar. To change the active Measurement Year: update the org’s PF-96 jurisdiction-profile compliance.active_measurement_year_version value. The next measure run computes under the new ruleset. No code deploy is required; the value flows through the PF-96 profile.
No hardcoded value sets. Selecting a Measurement Year selects a ruleset shape. The NCQA value-set OIDs themselves are loaded into the CL-51 measure-spec registry from the licensed NCQA portal (a human-verify-open gate). Do not expect FUA/FUI prod rates to be conformant until those per-MY OIDs are loaded — see the integration doc §7, gate 6.

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2. Mid-period integrity guarantee (NFR-integrity-1)

Toggling the Measurement Year mid-period does not overwrite or restate already-computed results. Each computed snapshot is written to cl_quality_measure_periods keyed (uniquely) on (org, measure, period, Measurement Year version) via a NULLS NOT DISTINCT unique index. So:
  • the prior-MY snapshot is preserved exactly as computed;
  • the new-MY computation starts on the next run and lands as a new row;
  • there is no silent overwrite — both rows coexist, distinguished by their MY stamp.
This means an admin can move from MY2025 to MY2026 partway through a reporting period without destroying the historical MY2025 figures that may already have been reported. (Illustrative only — no real patient data: a synthetic org’s FUA-7 row for period 2026-Q1 under MY2025 remains intact after the org switches to MY2026; the MY2026 FUA-7 row for the same period is added alongside it.)

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3. FUI high-intensity scope toggle — and the benchmarkability trade-off

NCQA defines FUI’s high-intensity denominator as residential treatment + acute-inpatient SUD (with withdrawal management). That is the default scope, and it is what makes a facility’s FUI rate comparable against NCQA-published benchmark rates. PF-96 exposes an opt-in expansion — ComplianceRules.fui_high_intensity_expansion — that adds PHP/IOP episodes to the FUI high-intensity denominator. Trade-off to weigh before enabling. Turning the expansion on gives a broader internal view of high-intensity follow-up (useful for programs that treat PHP/IOP as high-intensity), but the resulting FUI rate can no longer be compared to NCQA benchmark rates because the denominator no longer matches the published cohort. Leave it off for any FUI rate that will be reported externally or benchmarked; turn it on only for internal quality analysis where you understand the rate is non-comparable. The default-off / opt-in behavior is verified by acceptance criteria AC-4.1 (default) and AC-4.2 (opt-in).

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4. Payer-facing export — disabled by default (42 CFR Part 2)

FUA/FUI denominators are SUD-triggered, so any payer-facing or AHCCCS-facing export that identifies SUD treatment episodes is gated. Internal, org-scoped computation and dashboards are permitted under the existing HIPAA TPO exception; payer-facing export is disabled by default and fail-closed at the DB until:
  • the org explicitly enables payer export (cl_fua_payer_export_settings.payer_export_enabled), and
  • active 42 CFR Part 2 consent exists for the chart and disclosure purpose (cl_check_sud_consent()), with every permitted redisclosure written to the CL-11 redisclosure log.
Do not enable payer export until your compliance officer has confirmed the Part 2 consent basis (TPO consent, individual authorization, or QSOA) and the AHCCCS DAP measure-weighting question for the relevant payment year (see the integration doc §7, gates 8 and 10a-b).

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