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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 ZieglerOptum
  •  
Peter Muir
  •  
Cambia
  •  
Ann GallagherOptum
  •  
Luis SayagoDacarba
  •  
Ralph Saint-PhardHealow
  •  
Intepro
  •  
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 Thompson
  •  
Sushmita Kumari
  •  
Nandini GangulyScope Info Tech
  •  
CSHS
  •  
OHSU

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
  •  
Philips
  •  
Louis BedorCognosante


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

#22185

#22197

  • Date of start and end of proposed service is needed - not yet associated with the patient
  • Proposed adding wording that there's no query ability with non-PHI
  • CMS does not need PHI to be sent
  • 2 different mechanisms for invoking CRD
    • PHI
    • Non-PHI - send patient and coverage information compliant with de-identified profile, but also send draft order that we're looking for coverage requirements for, and it would include proposed start and end date for order
  • In EHR, what determines what CRD hook is going to be used - PHI vs. Non-PHI?
    • Would be determined in agreement with payer during set up and trust framework
    • Where are rules for set up defined?
      • Outside of CRD spec
      • There's a general expectation that within CDS Hooks there's a registration/set up process
  • From payer coverage perspective, is this a covered item under this benefit? Would need to know if the patient is in the gold/silver/platinum to determine if a service is covered
    • For most payers, would need PHI version to identify patient/plan/etc
    • This information is not relevant for CMS
  • Need help from CMS as the organization that would be using the Non-PHI version

Management


 Adjournment
Adjourned at 12:25pm ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval


Action items


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