Page tree
Skip to end of metadata
Go to start of metadata

Chair:  @Paul Knapp

Scribe: @MaryKay McDaniel

Call Logistics:  This call is at 11 AM ET, 10 AM CT, 9 MT, 8 AM PT, join using

Attendees - list maintained at the bottom of meeting notes.


Planning to ballot an artifact in the September 2019 cycle? PMO and Project Number BEFORE TSC approval of the PSS by April 7th.

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)

Approve previous Minutes

2019 JAN WGM Meeting Notes, not yet ready for approval

Proposed Agenda,

Ballot Reconciliation, Coverage Requirements Discovery

1) Out of cycle ballot request - Da Vinci PSS

Based on both the NPRMs (in particular the CMS NPRM) and feedback from HL7 FHIR Management Group (questioning the need for ballot for comment ballots of the FHIR IGs) , we are proposing to make changes in our HL7 IG ballot efforts for 2019.


    1. The CMS NPRM has start dates for exchange of member clinical data starting 1/1/2020.
    2. While we assume this date may move back, we still need to be prepared to have the IGs published as an STU in time for its use by our members
    3. Based on the current schedule, it is unlikely the IG will be published as an STU until Q1 of Calendar 2020.
    4. HL7 has been concerned with the short time frame to the ballot for comment in May and the immediate turn around for the STU ballot in September.
    5. We could use the input from NPRM comments as well as experience from May connectathon to produce more robust IGs.

 PSSs/IG Covered:

    1. Health Record Exchange (HRex)
    2. Clinical Data Exchange (CDex)
    3. Payer Data Exchange (PDex)
    4. Prior-Authorization Support (PAS)  (because its dependencies on CDex)

 Current :

    1. HRex, CDex, and PDex are scheduled for ballot for comment in May and STU ballot in September
    2. PAS is scheduled for STU ballot for May


    1. All four IGs for early ballot for September (early ballot in July vs August) for STU
    2. This should give us August and the first half of September to address ballot comments and prepare block votes for the September WG meeting.
    3. We anticipate that we could publish the resulting STU1 IGs in the mid-late fall of 2019 (in time to be used to address the interoperability issues raised by the NPRMs in a uniform manner.)
    4. We may  to update the PSS for PDex to include Payer to Payer exchanges

 We will be able to:

    1. Use the three months to develop a robust IG that will be reviewed multiple times by the responsible working group and the general community
    2. Have multiple  paid reviews to minimize the overhead on the responsible WGs
    3. Test at the May WG connectathon in Montreal.
    4. Test at a Da Vinci sponsored (but open) connectathon at the end of May
    5. Create and test robust reference implementation
    6. Create and use Touchstone test scripts for all of the exchanges


      • Some liked the idea of the BoC, but understands why it is needed. We didn't create the urgency, but we are responding to it (the NPRMs)
      • This committee will be reviewing in May/June time frame.
      • Ballot review for May needs to be converted to review. Need to coordinate that with ASIPP - the WG formally known as Attachments


Move to approve the Request for Out-of-Cycle Ballot, Notification of Intent to Ballot: Open 7/1/2019.

Laurie Burckhardt/ MaryKay McDaniel. 8-0-0

      • Health Record Exchange (HRex) Implementation Guide
      • Clinical Data Exchange (CDex) Implementation Guide
      • Payer Data Exchange (PDex) Implementation Guide
      • Prior-Authorization Support (PAS) Implementation Guide

2) Hospice Indicator.

** Linda will create a tracker. What more does the FM WG need to do?

Paul: Will create the extension in Coverage. Will add into current build. There is no US Core for Coverage (Core was a project).

Tracker 20361, added for R5

Need for indicators for Hospice, LTC, Disability and ESRD.  There is a need to have an indicator when a particular coverage type was invoked. 

There is a monthly file between Medicare (IDR).  Need code to indicate the type of coverage and span for when it applies.

Benoit perhaps had possible business case as well. 

Going to add something to COVERAGE at least a dated data element.  Complex element to be a code and date.  For the US, will need a US CORE code set.  Need code set to ID the types of subplan.  If putting into coverage, will need to be included in any coverage for which it has been invoked.  Will only be for the actual coverage it has been invoked.  It isn’t a status about the person.  It won’t be able to be used for things like pregnancy indicator.  There are other things other than hospice and it must be invoked by the patient (or whatever the process is).   

There are some coverage and other member alerts that limit or impact coverage (high use individual limited to a single pharmacy).  There might be other alerts that would be in a clinical sense, but that wouldn’t necessarily be in coverage.    This new thing is specific to patient invoked rather than limitations imposed on coverage by someone else.   When will change in coverage resource be made so the Da Vinci project, when will it be available for use (R5 in 2 years), but extension can be used in the interim. FM would develop the universal extension.

2) Anesthesia Billing Outreach update - MK

No update.

3) 3/26/2019 - 30 minutes

Payer Section Templates CCDA - Linda Michaelsen

 I would like to request time on your agenda to start talking about the Payer Section Templates.

 Collaborative CDA Template Review Process Pilot

Eventually FM will own/support 3 templates: THIS IS A PILOT. What does it mean for the WG to 'own'?

- C-CDA R2.1 Coverage Activity Entry
- C-CDA R2.1 Planned Coverage
- C-CDA R2.1 Policy Activity Entry


Added Items

Ballot Reconciliation







Management Next agenda

Tuesday, March 12, 2019 at 11:00 - 12:30 ET

 Adjourned at 12:30 ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval

Action items






Kathleen Connor
Paul Knapppknapp@pknapp.comKnapp Consulting Inc.
MaryKay McDanielmarykay.mcdaniel@cognosante.comCognosante
Benoit Schoefflerbenoit.schoeffler@almerys.comAlmerys
Alex Beckneralex.beckner@cerner.comCerner
Lou BedorLouis.Bedor@cognosante.comCognosante
Laurie Burckhardtlaurie.burckhardt@wpsic.comWPS
Tricia Chitwoodtricia.chitwood@cerner.comCerner
Susan LangfordSusan_Langford@bcbst.comBCBST
Linda Michaelsenlinda.michaelsen@optum.comOptum
Joe QuinnJoseph.Quinn@optum.comOptum
Mark Scrimshiremark@ekivemark.comCMS/NewWave
Najee Shafinajee.shafi@cognosante.comCognosante
Katie Sullivankatie.sullivan@cognosante.comCognosante

The MITRE Corporation

Patrick J LaRocqueplarocque@mitre.orgThe MITRE Corporation
Ray Delanoray.delano@cerner.comCerner
Larry Decellesldecelles@mitre.comMITRE
Robert Dieterlerdieterle@enablecare.usEnableCare
Ben Hamlinhamlin@ncqa.orgNCQA
Tom Twaitttwait@cerner.comCerner