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Chair: Mark Scrimshire

Scribe: Dana Marcelonis

 

Attendees

Present

Name

Affiliation

  •  
SureScripts
  •  
Regence
  •  
Optum
  •  
Michael BaillieUHC
  •  
Humana
  •  
BCBS AL
  •  
Rush
  •  
SureScripts
  •  
Rush
  •  
Cerner
  •  
Laurie BurckhardtWPS Health Solutions
  •  
Lindee ChinEdifecs
  •  
Independence Blue Cross
  •  
Allscripts
  •  
Regence
  •  
Didi DavisSequioa
  •  
InterSystems
  •  
BCBS IL
  •  
Allscripts
  •  
Cambia Health
  •  
Enable Care
  •  
David DodgeCambia Health
  •  
CAQH Core
  •  
Howard FollisJuxly
  •  
Reliant Medical Group
  •  
Lantana Consulting
  •  
SureScripts
  •  

  •  
Independence Blue Cross
  •  
GunjitZeOmega
  •  
Kenneth Hall
  •  
NCQA
  •  
Optum
  •  
Jackie HardisonHumana
  •  
Cigna
  •  
HealthLX
  •  
ZeOmega
  •  
BCBSA
  •  
Point of Care Partners
  •  
Edifecs
  •  
Heather KennedyBCBST
  •  
Edifecs
  •  
Sathaya KrishnasamyAnthem
  •  
BCBS AL
  •  
Stephen LaneSutter Health
  •  
InterSystems
  •  
Anthem
  •  
Luis MaasEMR Direct
  •  
Erin MajderBCBS IL
  •  
Point of Care Partners
  •  
Cognosante
  •  
BCBS AL
  •  
Lloyd McKenzieGevity
  •  
Optum
  •  
Humana
  •  
MaxMD
  •  
Stratametrics
  •  
Sean ParsonsBCBS OK
  •  
Scott Parsons
  •  
BCBS AL
  •  
Allscripts
  •  
HealthLx
  •  
Optum
  •  
Optum
  •  
Regence
  •  
InterSystems
  •  
NewWave
  •  
NewWave
  •  
ZeOmega
  •  
Anne Marie SmithNCQA
  •  
InterSystems
  •  
UHC
  •  
Casenet
  •  
Cigna
  •  
HealthLX
  •  
Independence Blue Cross
  •  
Joel WalkerHealthLX
  •  
Holly WeeksRegence
  •  
BCBS AL
  •  
Darrell Woelk
  •  
Cambia
  •  
Brent Woodman
  •  
Anthem
  •  
Cambia
  •  
NewWave
  •  
Edifecs
  •  

  •  

  •  
YuriyHealthLX
  •  
Stephen MacVicarMITRE
  •  
Anna MeisheidCMS
  •  
Epic
  •  
Paul Knapp
  •  
Dave FosterEdifecs
  •  
John FeloExpress Scripts
  •  
Ken Lord
  •  
Roland GamacheAHRQ
  •  
Epic
  •  
Jennifer Joe
  •  
Stephen McVicarMitre
  •  
Joe HamiltonUnity Point
  •  
Matthew FloresAdvent Advisory Group
  •  
Providence
  •  

  •  
EMR Direct
  •  
Barbara WoodPNC
  •  
Eshaa DhalleClinicalWorks
  •  
Katherine RuizUNC Health
  •  
Zach Heath
  •  
Centene
  •  
Veradigm
  •  
Kenneth Foster
  •  
Cigna
PresentNameAffiliation
  •  
Tibco
  •  
Aim Specialty Health
  •  
Christy Dodson
  •  
BCBSM
  •  
Allscripts
  •  
BCBSFL
  •  
BCBSM
  •  
CMS
  •  
Mike HurleyBRYJ Healthcare
  •  

  •  
Tori WillowsWellcare
  •  

  •  
Nandini GangulyEMDI - Scope Info Tech
  •  
Moxe Health
  •  
Jim McKinleyMedicaid Alabama
  •  
BCBST
  •  
Bart CarlsonAzuba
  •  
Deepthi ReddyMettle Solutions
  •  
Allscripts
  •  
Eric SullivanInovalon
  •  
David Hill Mitre
  •  
Pallavi TalekarScope Info Tech
  •  
Ralph Saint-PhardHealow
  •  
Scott SwihartSumma Health
  •  
India DuncanOptum
  •  
Jason CassidyMoxe Health
  •  
Praveer MathurWellcare
  •  
Megan Soccorso

Cigna

  •  
Prashanth GolcandaLumeris
  •  
Rajesh Godavarthi
  •  
Availity
  •  
Susan LestinaAHA
  •  
Bob BowmanCAQH
  •  
Thomas KesslerCMS
  •  
Patrick Edwards
  •  
Briana BarnesScope Info Tech
  •  
Kishore MetlaMettle Solutions
  •  
John DonnellyInterpro
  •  
Lorraine DooCMS
  •  
Melanie JonesCMS
  •  
Rim Cothren
  •  
Yolanda VillanovaCMS
  •  
Kathleen Connor
  •  
Manoj KumarBCBSFL
  •  
Saul KravitzMitre
  •  
Srinivas KonchadaCentene Corporation
  •  
Sheryl TurneyAnthem
  •  
Helina Gebremariam
  •  
Mike NovalesBCBSIL
  •  
Ric LightHumana
  •  
Ann GallagherOptum
  •  
Chris KlesgesMitre
  •  
Adam GronskyHealth Fidelity
  •  
CaseNet
  •  
Anthem
  •  
CMS
  •  
eClinicalWorks
  •  
Healow
  •  
Interfaceware
  •  
Mark RucciSpectramedix
  •  
Carie HammondAEGIS
  •  
Anthem
  •  
Cindy MonarchBCBSM
  •  
ONC
  •  
Dawn PerreaultBCBSM
  •  
Kyle ZumsteinAvaility
  •  
Nancy SpectorAMA
  •  
Bruce WilkinsonBenmedica
  •  
Cara BarryAvality
  •  

Chris Johnson

BCBSAL
  •  
Duane WalkerBCBSM
  •  

  •  
Greg LindenLinden Tech Advisors
  •  
Mario JarrinChange Healthcare
  •  
Megan Smith-HallingsheadRegence
  •  
Patrice KuppeSurescripts
  •  

  •  
MCG
  •  
ONC
  •  
Surescripts
  •  
NCPDP
  •  
Anupam ThakurBCBSFL
  •  
Jonathan HutchinsBCBST
  •  
Anthem
  •  
Sunitha Godavarthi
  •  
Christopher GraconIndependent Health
  •  
Labcorp
  •  

  •  
James DerricksonIntersystems
  •  
Douglas DeShazoCognizant
  •  
Neetha JosephCognizant
  •  

  •  
Terry MayMitre
  •  
Rutika
  •  
Ashley H. MaplesExpress Scripts
  •  
Brody BrodockAllscripts
  •  
Michael BrodyCME Online
  •  
Theressa BaumannBCBS AL
  •  
Mona ChandrapaleClinicalWorks
  •  
Optum
  •  
Aakash DeliwalaeClinicalWorks
  •  
Mayo
  •  
Eddy NievesEpic
  •  
Shaheer
  •  
Stanley Nachimson
  •  
Anthony SmithUNC Health
  •  
Howard Cohen
  •  
Minaei BehnazFDA
  •  
BCBSA
  •  
Shilesh Nairgdit
  •  
Elkhan YusubovNewWave

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Minutes Approved as Presented 


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Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

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



Connectathon Kick-Offs

PDex Ballot Comment Review

FHIR-23410

FHIR-23409

  • In cases where can't write resources directly through FHIR API, it's up to the specific EHR implementation to determine how to store/make the information available - other comments have addressed this issue

FHIR-23400

  • When a member moves to another plan, they'll indicate they want to pull forward information from a previous plan (or the new plan will do it)
  • If the old plan has 2 dependents, but new plan only has 1 dependent, they can only pull forward the information for the subscriber and the 1 dependent, not all

FHIR-23399

  • Clarify that health plan can only supply information they have (may not have a complete medical history of the patient)
  • Potentially should address this in beginning of IG so that we don't need to clarify in every section

FHIR-23398

  • Clarify subscriber vs. member - they are not synonymous
    • Subscriber - holder of policy
    • Member/patient
  • X12 uses subscriber and dependent
  • Need to be consistent throughout the IG
  • Coverage resource - either the subscriber or the member
  • Need to clarify in the Actors section of the IG that there are other terms that are used in payer space for this particular concept (e.g., Dependent, Beneficiary)

FHIR-23390

FHIR-23388

  • IG does not exclude dental/vision information

FHIR-23386

  • IG will provide a link to US Core profiles for relevant resources for data mapping purposes

FHIR-23382

FHIR-23380

  • IG will provide guidance based on final rule


Next AgendaBallot comment review
 Adjournment

Adjourned at 12:59pm ET


Supporting Documents


Action items

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