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Chair:  Lloyd McKenzieRobert Dieterle

Scribe: Dana Marcelonis
 

Attendees

Present

Name

Affiliation

  •  
IBC
  •  
Lloyd McKenzieGevity
  •  
Enablecare
  •  
Aaron Kohn
  •  
Duane WalkerBCBSM
  •  
Michael CabralCMS
  •  
Susan BellileAvaility
  •  
Susan LangfordBCBST
  •  
Sonja Ziegler
  •  
Peter Muir
  •  
Cambia
  •  
Ann GallagherOptum
  •  
Luis SayagoDacarba
  •  
Ralph Saint-PhardHealow
  •  
Interpro
  •  
Celia Bowen
  •  
Isaac VetterEpic
  •  
Dawn PerreaultBCBSM
  •  
Jeffrey DanfordAllscripts
  •  
Rachel E. Foerster
  •  
Seth ParadisHealow
  •  
Sheryl TurneyAnthem
  •  
Serafina Versaggi
  •  
Rohit ShindeeClinical Works
  •  
Pallavi TalekarScope Info Tech
  •  
Barbara AntunaAIM
  •  
Brandon RaabAnthem
  •  
Chris JohnsonBCBSAL
  •  
Clarissa WinchesterBCBSAL
  •  
Sequoia Project
  •  
Rachel Goldstein
  •  
KasiCambia
  •  
Bob

Present

Name

Affiliation

  •  

  •  
JPSys
  •  
Roland GamacheAHRQ/CEPI
  •  
Jeanie SmithBCBSFL
  •  
Jim St. ClairDinocrates Group
  •  
Durwin DayBCBSIL
  •  
Patrick HarenCigna
  •  
Anthem
  •  
Athenahealth
  •  
Katherine LuskChildrens
  •  
Laurie BurckhardtWPS Health Solutions
  •  
Manoj KumarGuidewell
  •  

  •  
Minil Mikkili
  •  
Scott M. RobertsonKP
  •  
David Kates
  •  
Sreenivas MallipeddiMCG
  •  
Thomas J. KesslerCMS
  •  
Eric ThomasIBC
  •  
Tony LittleOptum
  •  
Yolanda VillanovaCMS
  •  
TorQuailla Aultman
  •  
Brian PoteetBCBST
  •  
Brad Prentice
  •  
Heather KennedyBCBST
  •  
Jim TaylorTibco
  •  
Jodie ZellerhoffCambia
  •  
Labcorp
  •  
Nick RadovUHC
  •  
Mary Kay McDanielCognosante
  •  
Joseph QuinnOptum
  •  
Julia Chan
  •  

  •  
BCBSM
  •  
Marianna SinghCAQH
  •  
Neeraja
  •  
Cambia
  •  
Anthem
  •  
AMA


Minutes Approved as Presented 


This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."


Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)
ManagementReview ANSI Anti-Trust Policy



CRD Implementation Guide Link

http://hl7.org/fhir/us/davinci-crd/2019May/



Ballot Comment Triage/Review

#22256

  • CPT can't be published in IG due to licensing issues
    • Chat comments:
      • HPCS codes are open and are considered a type of CPT
      • ICD-10-PCS for procedures in US

#22257

  • Part B drugs (under medical benefit) are not covered by NCPDP
  • Don't want to use examples under prescription drug benefit which would be covered by NCPDP
  • Example is using CDS to propose an alternative - that would probably be done outside of NCPDP (prior to the order)
  • May not be an inappropriate example because haven't sent the order to the pharmacy at this point
  • Change example to immunosuppressive drug (under Part B)- Robert Dieterlewill provide codes/instructions

#22258

  • PHI vs. non-PHI in the initial request
    • Unless we want to mandate that every EHR shall record the actual plan ID and member ID or they can't use CRD, then every payer needs that information because they need to decide which plan the patient is covered under - payer uses patient demographics to determine what plan/benefit the patient has
      • Medicare FFS only has one set of coverages so this doens't matter
      • Can't require non-PHI because most commercial plans wouldn't be able to respond to the request
    • PHI is a requirement in situations where there is not a single plan
  • Scope of access is granted by EHR (not payer)
  • Terrence Cunninghamwill follow up with his team re: whether or not this meets AMA policy needs, and if he needs to pull this item from the block vote he will

#22260

  • Outside scope of CRD IG?
    • "Authorized user" intended to be the physician - they should be able to access the audit log
    • This may be an organizational policy issue and not a standards issue
      • Could define a standard for exposing that data, but are there any systems that would implement that standard
  • Add language to IG - organization should make it accessible to authorized users to resolve issues related to coverage that may occur

#22716

  • Clinical systems may have multiple components (e.g., scheduling, practice management, EHR, etc.)
  • Need to add content to IG to highlight this issue
  • EHR systems should create interfaces between modules 

#22185

  • In person comment - commenter not in attendance
  • Proposed disposition populated in Gforge

#22190

  • In person comment - commenter not in attendance
  • Proposed disposition populated in Gforge

#22193

  • In person comment - commenter not in attendance
  • More details needed for SMART 'what if' scenarios
  • Proposed disposition populated in Gforge

#22197

  • In person comment - commenter not in attendance
  • Proposed disposition populated in Gforge


  • In person comments need to be reviewed by commenters - 8 total
  • Robert Dieterle will follow up with commenters and ask them to attend next week's call if they disagree/items need to be discussed further
  • Call will be cancelled next week if they can't attend

ManagementNext agenda
  • Review in person comments if commenters can attend next week - if not, cancellation notice will be sent out

 Adjournment
Adjourned at 12:56pm ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval


Action items


Create Decision from template