diff --git a/src/main/java/org/opencds/cqf/tooling/visitor/ElmOperatorRequirement.java b/src/main/java/org/opencds/cqf/tooling/visitor/ElmOperatorRequirement.java
new file mode 100644
index 000000000..c19dbf446
--- /dev/null
+++ b/src/main/java/org/opencds/cqf/tooling/visitor/ElmOperatorRequirement.java
@@ -0,0 +1,26 @@
+package org.opencds.cqf.tooling.visitor;
+
+import org.hl7.elm.r1.Expression;
+import org.hl7.elm.r1.VersionedIdentifier;
+
+import java.util.HashSet;
+import java.util.LinkedHashSet;
+
+public class ElmOperatorRequirement extends ElmExpressionRequirement {
+    private HashSet<ElmRequirement> requirements = new LinkedHashSet<ElmRequirement>();
+    public Iterable<ElmRequirement> getRequirements() {
+        return requirements;
+    }
+
+    public ElmOperatorRequirement(VersionedIdentifier libraryIdentifier, Expression expression) {
+        super(libraryIdentifier, expression);
+    }
+
+    @Override
+    public ElmExpressionRequirement combine(ElmExpressionRequirement requirement) {
+        if (requirement != null) {
+            requirements.add(requirement);
+        }
+        return this;
+    }
+}
diff --git a/src/main/java/org/opencds/cqf/tooling/visitor/ElmRequirementsVisitor.java b/src/main/java/org/opencds/cqf/tooling/visitor/ElmRequirementsVisitor.java
index d65328719..c7fe81b72 100644
--- a/src/main/java/org/opencds/cqf/tooling/visitor/ElmRequirementsVisitor.java
+++ b/src/main/java/org/opencds/cqf/tooling/visitor/ElmRequirementsVisitor.java
@@ -3,6 +3,8 @@
 import org.cqframework.cql.elm.visiting.ElmBaseLibraryVisitor;
 import org.hl7.elm.r1.*;
 
+import java.util.Iterator;
+
 public class ElmRequirementsVisitor extends ElmBaseLibraryVisitor <ElmRequirement, ElmRequirementsContext>{
 
     public ElmRequirementsVisitor() {
@@ -285,18 +287,29 @@ public ElmRequirement visitChildren(BinaryExpression elm, ElmRequirementsContext
              */
             // TODO: Normalize to DNF
             case "And": {
-                ElmExpressionRequirement left = (ElmExpressionRequirement)visitElement(elm.getOperand().get(0), context);
-                ElmExpressionRequirement right = (ElmExpressionRequirement)visitElement(elm.getOperand().get(1), context);
+                ElmRequirement left = visitElement(elm.getOperand().get(0), context);
+                ElmRequirement right = visitElement(elm.getOperand().get(1), context);
 
-                return new ElmConjunctiveRequirement(context.getCurrentLibraryIdentifier(), (And)elm).combine(left).combine(right);
+                if (left instanceof ElmExpressionRequirement && right instanceof ElmExpressionRequirement) {
+                    return new ElmConjunctiveRequirement(context.getCurrentLibraryIdentifier(), elm)
+                            .combine((ElmExpressionRequirement)left)
+                            .combine((ElmExpressionRequirement)right);
+                }
+
+                throw new IllegalArgumentException("Expected ElmExpressionRequirement");
             }
 
             case "Or": {
+                ElmRequirement left = visitElement(elm.getOperand().get(0), context);
+                ElmRequirement right = visitElement(elm.getOperand().get(1), context);
 
-                ElmExpressionRequirement left = (ElmExpressionRequirement)visitElement(elm.getOperand().get(0), context);
-                ElmExpressionRequirement right = (ElmExpressionRequirement)visitElement(elm.getOperand().get(1), context);
+                if (left instanceof ElmExpressionRequirement && right instanceof ElmExpressionRequirement) {
+                    return new ElmDisjunctiveRequirement(context.getCurrentLibraryIdentifier(), elm)
+                            .combine((ElmExpressionRequirement)left)
+                            .combine((ElmExpressionRequirement)right);
+                }
 
-                return new ElmDisjunctiveRequirement(context.getCurrentLibraryIdentifier(), (Or)elm).combine(left).combine(right);
+                throw new IllegalArgumentException("Expected ElmExpressionRequirement");
             }
 
             // TODO: Rewrite
@@ -417,7 +430,8 @@ public ElmRequirement visitNot(Not elm, ElmRequirementsContext context) {
 
     @Override
     public ElmRequirement visitIf(If elm, ElmRequirementsContext context) {
-        return super.visitIf(elm, context);
+        // TODO: Rewrite the if as equivalent logic
+        return new ElmOperatorRequirement(context.getCurrentLibraryIdentifier(), elm);
     }
 
     @Override
@@ -427,12 +441,36 @@ public ElmRequirement visitCaseItem(CaseItem elm, ElmRequirementsContext context
 
     @Override
     public ElmRequirement visitCase(Case elm, ElmRequirementsContext context) {
-        return super.visitCase(elm, context);
+        // TODO: Rewrite the case as equivalent logic
+        ElmOperatorRequirement result = new ElmOperatorRequirement(context.getCurrentLibraryIdentifier(), elm);
+        ElmRequirement childResult = null;
+        if (elm.getComparand() != null) {
+            childResult = this.visitElement(elm.getComparand(), context);
+            if (childResult instanceof ElmExpressionRequirement) {
+                result.combine((ElmExpressionRequirement)childResult);
+            }
+        }
+
+        for (CaseItem ci : elm.getCaseItem()) {
+            childResult = this.visitElement(ci, context);
+            if (childResult instanceof ElmExpressionRequirement) {
+                result.combine((ElmExpressionRequirement)childResult);
+            }
+        }
+
+        if (elm.getElse() != null) {
+            childResult = this.visitElement(elm.getElse(), context);
+            if (childResult instanceof ElmExpressionRequirement) {
+                result.combine((ElmExpressionRequirement)childResult);
+            }
+        }
+
+        return result;
     }
 
     @Override
     public ElmRequirement visitNull(Null elm, ElmRequirementsContext context) {
-        return super.visitNull(elm, context);
+        return new ElmExpressionRequirement(context.getCurrentLibraryIdentifier(), elm);
     }
 
     @Override
@@ -726,17 +764,17 @@ public ElmRequirement visitDateTimeComponentFrom(DateTimeComponentFrom elm, ElmR
 
     @Override
     public ElmRequirement visitTimeOfDay(TimeOfDay elm, ElmRequirementsContext context) {
-        return super.visitTimeOfDay(elm, context);
+        return new ElmExpressionRequirement(context.getCurrentLibraryIdentifier(), elm);
     }
 
     @Override
     public ElmRequirement visitToday(Today elm, ElmRequirementsContext context) {
-        return super.visitToday(elm, context);
+        return new ElmExpressionRequirement(context.getCurrentLibraryIdentifier(), elm);
     }
 
     @Override
     public ElmRequirement visitNow(Now elm, ElmRequirementsContext context) {
-        return super.visitNow(elm, context);
+        return new ElmExpressionRequirement(context.getCurrentLibraryIdentifier(), elm);
     }
 
     @Override