Chair: Mark Scrimshire
Scribe: Vanessa Candelora
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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) |
|---|---|---|---|
| Management | Review ANSI Anti-Trust Policy |
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| IG Publishing Updates | |||
| Implementer Resources | Da Vinci Implementer Support Page Implementers can take advantage of tools: See the Reference links on the Payer Data Exchange (PDex) page to access links for Reference Implementations, sandboxes, test scripts, and more! | ||
| Formulary Recent Questions and JIRA Trackers created per Zulip | Saul Kravitz has created trackers for all open questions from Zulip. These issues are in discussion with the HL7 Pharmacy workgroup to determine the best approach and we will come back to this meeting with resolutions/responses in the coming weeks. Ticket Number For reference (or use this public Jira query link)
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Discussion with Lorraine, Stanley, around process for asking technical questions. Da Vinci is working on this and the implications. CMS may add a link to Zulip to ask their Technical questions. Share Implementer support and process for questions on DV Community Roundtable maybe. | |||
| Implementer Support Questions (PDex, Formulary, Plan Net) | Call to All Implementers: We learn as a community and iterate on the IGs through real world experience, so your contributions are welcome! Please come with your questions. Options: 1) Send them to us on Zulip:
2) Ask questions live on the call 3) Edit and add your question to this page (in this box under "Question") Ron raised the interest in continuing the discussion on Member Match. We will continue the discussion in the coming weeks. Question: Mark and Raj raised the concern with the FormularyDrug CoveragePlan Cardinalities FHIR-30923, FHIR-29670 - Looking for timing of when this will be addressed. We need to determine when to proceed with publication, waiting for some more feedback on the guide. STU update process - 14 day review period. We are trying to balance the Coverage Area. Can the return response be restricted to the person searching. Can search by address, postal, code, and give a list of postal codes to have a search in just there. The "near" search operation (gps radius) was removed after ballot because it was deemed to be too much of a burden to implement. This is covered in the Reference Implementation.
CMS Final Rule Questions and Answers log, question #6017 Some other notes: FAST doesn't recommend IGs, they are focused on scalable solutions. PCDE is to exchange active treatments that an individual is on for continuity of care when a patient went from one Insurer to another. PA can be part of this, but it's not a replacement for PDex. Tony Benson might be back, hurray! Question: can I have more than one extension if the drug is part of 5 plans, can they have 5? Plan ID is 1..1. The 2 or more is you need one from column
Notes for IG Update to Formulary: list the mandatory elements (see screenshot) before the non-mandatory. Saul Kravitz | ||
PDex IG Links and Updates PDex Supplemental Guides | Updated to 0.1.29 on build.fhir.org: http://build.fhir.org/ig/HL7/davinci-epdx/index.html. Source code is here: https://github.com/HL7/davinci-epdx
| Presented to FM on 10/20 | |
| Other discussion | |||
| Next Week | |||
| Adjournment | Adjourned at 12:58pm | ||
Outline Reference | Supporting Document |
|---|---|
| Minute Approval | |
| PDex Companion Guides | PDex IG Companion Guide List |
| CARIN CPCDS to US Core Mapping | Latest draft CARIN CPCDS Mapping document: CARIN Mapping to FHIR interim 2020 0513.xlsx DRAFT - PDEX US Core Mapping from CPCDS source: ResourceMappingUSCoreCPCDS-2020-05-29-v26.xlsx |
| PDex - US Core inter-relationship |
Source PowerPoint: PDEXandUSCoreRelationship.pptx |
| Da Vinci is seeking answers to open questions and clarifications needed on the implementation and operational needs of the upcoming CMS Patient Directed API Rules. | Find initial questions and corresponding answers shared from our colleagues at CMS here |
Action items
- PDex Pharmacy list - pharmacy count and mix: how can the pharmacy count and mix (as required by CMS) be included in the response PDex resources? Scott M. Robertson posted question 2020-11-20 PDex Meeting - 2/11/2021 VC asked about status on CMS Question set 9.
Attendees - 39
Rakesh Mathew Daniel Lilavois Patricia R Harbin Shalabh Gautam Kamaraj Kaliaperumal, Carefirst Bhanu Vemuri Narasimha Murthy Accenture Google Cloud Healthcare Maggie Mellon Courtney BlandPresent Name Affiliation CMS BCBST Deepthi Reddy Mettle Solutions Allscripts Eric Sullivan Inovalon MITRE India Duncan Optum Availity Susan Lestina AHA Bob Bowman CAQH Thomas Kessler CMS Patrick Edwards Briana Barnes Scope Info Tech Kishore Metla Mettle Solutions John Donnelly Interpro Lorraine Doo CMS Melanie Jones CMS Rim Cothren Yolanda Villanova CMS Manoj Kumar BCBSFL MITRE Srinivas Konchada Centene Corporation Sheryl Turney Anthem Helina Gebremariam Mike Novales BCBSIL Ric Light Humana Ann Gallagher Optum Chris Klesges Mitre Adam Gronsky Health Fidelity CaseNet Anthem CMS eClinicalWorks Healow Interfaceware Mark Rucci Spectramedix Anthem Cindy Monarch BCBSM Michael Kim Cognosante Jim Catan Accenture BCBSA Jia Chen Robert Dieterle Jeff Eastman Ernestine Cooper Jason Teeple CIGNA Lloyd McKenzie Mary Winter Rachel E. Foerster Tom Grannan Azuba Tony Benson BCBS AL Independence BC Henry Archibong Inovalon HL7 Consultant Abdul Sattar Anirudh Choudhary Todd Biske ESI Darrell Woelk Doug Stoss Rick Lisseveld Aegis LakshminarayananSaravanan Laurie Burckhardt WPS Health Plan Kevin Lynch Inovalon Joseph Minieri MITRE Durwin Day BCBS IL Pamela West Ravi Thakkar Aetna UO Aetna Swati Nanda Aetna CVS Health Cyrus Kevin MITRE Fred Harmon Ready Computing Blue Cross NC Michael Ryan NCQA HealthSparq CVS/Aetna Dorothy Lee NCQA Khoa Nguyen Suma Addagadde BCBSNC
Chris Johnson Scott M. Robertson David ClowersPresent Name Affiliation Nancy Spector AMA Bruce Wilkinson Benmedica Avality BCBSAL MCG ONC Surescripts NCPDP Anupam Thakur BCBSFL Jonathan Hutchins BCBST Anthem Sunitha Godavarthi Christopher Gracon x12 Labcorp James Derrickson Intersystems Cognizant Neetha Joseph Cognizant Kaiser Permanente MITRE Rutika Express Scripts Brody Brodock Allscripts Michael Brody CME Online Theressa Baumann BCBS AL Mona Chandrapal eClinicalWorks Optum Aakash Deliwala eClinicalWorks Mayo Epic Shaheer Stanley Nachimson Anthony Smith UNC Health Howard Cohen Minaei Behnaz FDA BCBSA Shilesh Nair gdit NewWave MaxMD BC Idaho Edward Castagna Altarum Andrea Kent CoverMyMeds Carrie Denny Kim Pham Celine Lefebvre AMA Edifecs Josh Lamb UPMC Keya Shah Casenet Gevity MITRE Mrugen Mehta eClinicalWorks Revathi Jayakumuar Supriya Bapi Bhera Matt Dyer Vyne Sree Vijetha Vegi C-HIT BCBSA Rich Bloch Lumedic Cigna Paul Knapp Ron Urwongse CAQH Anand Raghavan HealthLX Ezequiel Morles Frank McKinney Hanna ? Brett Rauschke Carolyn McKinney Clarissa Winchester BCBS AL JC HealthShare Exchange (HSX) River Wong Rob McClure MD Partners Ronald Wampler Derrick Woolridge Beata Ferraiz Ed Donaldson Consultant with Humana Julie Burgoon Mark Neumuth Aetna Raj Sankuratri Aetna Dr. Cheryl D. Lohman Germantown, MD | Family Physician Barbara Valeno Eshaa Dhall eclinicalworks Angie Brandon Bryan Briegal ACP