2019-05-24 PA Support Meeting

• MA, OH, MN(?)
• Peter Muir chat comment - Prior Auth State Law chart: https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/arc-public/pa-state-chart.pdf

• John Kelly chat comment - Looks like ther are 25 States with rules that require payer response (approved/denied) within 1-3 days (sometimes business days)

• Robert Dieterle will provide info to Jean Duteauby end of day 

Attestation vs. structured data

• There's something in between documented specific values for a lab test for example vs. a condition exists and there's accompanying information
• From a commercial payer point of view, if only the ones with a specific diagnosis could be fully automated then most wouldn't be automated 
• Tell me what's going on with the patient, and then let the payer rules engine make a determine based on that - this would support many real-time use cases
• If it can be done in a questionnaire, great - it can also be done by accessing R4 US Core profiles on supported resources

• Embed FHIR into CDA unstructured section? No - MIME type that allows for XML or JSON - this would require revision to CDA

• This could be implemented a different way, but wouldn't be consistent with current regulations