Agenda:

Remember the Antitrust Statement, see above

• Review/Approve 2/21/2023 Interim Meeting Minutes
• Announcements - see announcements row below
• Da Vinci -
  • Payer Identifier Discussion (cont?)
  • PCT - review the PCT draft product brief info at the bottom of the publication request (items 37 and below on the page below) Patient Cost Transparency, Release 1 - US Realm  Rick can attend from 11:30 am – 12:00 pm ET  Mainly need to be sure we check off items 37 and 38 so FMG can see that FM approves.
• Review applied R5 tickets
• May WGM Agenda
• Additional items???
  • THO Terminology changes
  • PAS Block Vote #13
  • ATR Update

• For next week:  Bob would like to have discussion on a payer identifier. What do we do prior to the National Directory? Context is the US realm. bob will pull together a set of talking points. 

2/28/2023:

V2 to FHIR Mapping Review/Updates. 

• Kathleen was monitoring the work
• see:  2023-02-06-09 v2-FHIR - Orders & Observations - Confluence (hl7.org)
• see also:  Segment Mapping - Orders & Observations - Confluence (hl7.org)
• spreadsheets:  

Weekly Call Minutes

Review & Approve Interim Meeting 2/21/2023

Agenda accepted by unanimous consent.

ANNOUNCEMENTS

• • Monthly Reminders to Co-Chairs:
    • Standards approaching expiration: 
      • https://confluence.hl7.org/display/HL7/ANSI+Standards+approaching+expiration
    • STUs Expiring in the Next 6 Months
      • https://confluence.hl7.org/display/HL7/STUs+Expiring+in+Next+6+Months
  • Upcoming PSS and NIB Deadline Dates for Future Ballot Cycles
    • All deadline dates can be seen on the new Balloting, Content Submission, Voting, and Working Group Meeting Schedules on Confluence at:
    • https://confluence.hl7.org/display/HL7/HL7+Calendars

• Next Call 3/7/2023
• FM Co-Chair calls:
  • NEXT Co-Chair Call - 3/6/2023

Da Vinci

• Payer Identifier Discussion

2/21/2022:

challenge:  what is the correct payer/plan and how do we determine (define).  No national source for a plan identifier

On the national level, national standard and there is only 1 instance. can always look it up.

Today there is no unique identifier for the payer/provider. There is no standard. 

The system becomes the national directory. Becomes the national assigner of identities.

NAIC, is it unique? NAIC calls it a producer id.  Producer Database (PDB) | NIPR

No national payer database

Digital Certificate ID - what happens when a new cert is issued?

2/21/2022:

Bob putting out block votes tonight, please put on agenda for next week vote.

Da Vinci PAS Block Vote #13

PAS Block Vote 13 containing 17 tickets has been posted to the FM listserv. The vote will take place on 2/28/2023 FM call
The following is a link to JIRA for block vote 13: 

2/28/2023.

No tickets pulled

Motion to approve all tickets as . Bob Dieterly / Jeff Brown 9-0-1

DA Vinci PCT Update

2/28/2023.

• Product Brief reviewed by FM
• Motion to approve the product brief section of the publication request. Rick Geimer/Jeff Brown 10-0-0

• Institutional/Professional profiles
  • Diagnosis:All Slices
    • the slices with the discriminator
    • Fixed pattern
    • Type was there for ICD-10 or ICD-11 or SNOMED
    • Lloyd's point was that a single diagnosis could be admitting, principal patientReasonForVisit
    • Type should be 1..1. All agree 
    • Motion to push back on the suggested changes at FMG
    • Paul will attend FMG this week

Da Vinci - Risk-Based Lists

4th Meeting of the month Agenda (regularly), 10-15 minutes for Risk-Based Lists:  

Risk Adjustment - Da Vinci - Confluence (hl7.org)

PSS:  PSS for Risk Based Contract Member Identification (Updated) - Financial Management - Confluence (hl7.org)

2/28/2023.

• Dragon. Working through the ballot reconciliation. 4 tickets left. Will be sending block votes in for review and approvals.
• Will have a track at the May connectathon.

Tickets to review for R5

These are the tickets from the 10/11/2022 call:  

Jira Filters: 

For Co-Chair Call:  

project = FHIR AND issuetype in ("Change Request", Comment, Question, "Technical Correction") AND  "Resolution Vote" is not empty AND Specification = "FHIR Core (FHIR) [FHIR-core]" AND "Work Group" = fm and status not in ("Applied")

Resume at 22763

Jira Filter:  Applied for R5 - Ballot

project = FHIR AND issuetype in ("Change Request", Comment, Question, "Technical Correction") AND status in (Applied) AND Specification = "FHIR Core (FHIR) [FHIR-core]" AND "Work Group" =

Needs Negative ballot vote

• 37594
  • 12/6/2022. Reviewed, will update.
  • 2/21/2023. Complete - applied
  • 
• 34221
  • 12/6/2022. THO update, will not be done for R5. 
  • The value set is an example value set
  • Must go through THO
• 33244
  • 12/6/2022. Reviewed, approved, will update
  • 2/21/2023. THO update, will not be done for R5.
• FHIR-32797    Add Trace Numbers to the base specification
  • 12/6/2022. Reviewed, will update
    
    • From SEP 2022 WGM Meeting minutes: FHIR-32797 - Add trace numbers to base specification - This is equivalent to the X12 TRN segment
  • 2/21/2023. Complete - applied

• FHIR-32776    Add more guidance on the expected use of adjudication and supportingInfo

  • 12/6/2022.  Reviewed, will update
    • From SEP 2022 WGM Meeting minutes:  FHIR-32776 - Guidance for adjudication and supportingInfo - we want to do it as described in ticket
  • 2/21/2023. Complete - applied
  • 
• 32075  Clarifing text between ClaimResponse.item, noteNumber and ClaimResponse.processNote
  • 12/6/2022. Reveiwed, will update.
  • 2/21/2023. Complete - applied
  • 
• 31678 
  • 12/6/2022. Reviewed, will update. 
  • 2/22/2023. Complete - applied
  • 2/28/2023. QA'd. Resolution = Applied

• FHIR-31062    Create a "Dates" Backbone element

  • 12/6/2022. Reviewed, will update 
    • From SEP 2022 WGM Meeting minutes: FHIR-31062 - Create Dates backbone - looking for examples of what would be fixed with the proposed Dates backbone
  • 2/23/2023. Complete - applied
  • 2/28/2023. QA'd. Resolution = Applied
    • NOTE: couldn't name it 'dates', changed to "Event". 
• FHIR-31061    Add a resource level error.
  • 12/6/2022. RE-Open Ticket to remove, "Add a resource level error for an error that applies to the overall resource."
  • Motion to re-open. Chris Cioffi / Jeff Brown. 8-0-0
  • Remove the 1st disposition, "Add a resource level error for an error that applies to the overall resource."  Leaving the rest of the disposition
  • Motion to approve the new disposition. Chris Cioffi / Mary Kay McDaniel. 7-0-2
  • Will update
  • 2/24/2023. Complete - applied
  • 2/28/2023. QA'd. 
    • on claim response and eligibility response - NOT on EOB
    • Complete error structure needs to be added on the EOB Resource!!!!
• 30929 -   THO Update  Vocabulary Update Payee Type VS/CS
  • 12/6/2022. THO Update, will not be done for R5
• FHIR-30502    THO Update. Add values to Code System Adjudication
  • 12/6/2022. THO Update, will not be done for R5

Start here 12/13/2022:  

• 29687. Add encounter 
  • 12/6/2022. Review next week. Encounter was already added, the words are different. 
  • 12/13/2022. "Medical encounters related to this claim" (29687).
    • The Spec currently says "The encounters during which this claim was created or to which the creation of this record is tightly associated."
    • 3 tickets to add encounter at the header:
      • this one FHIR-29687
      • FHIR-30337 - Getting issue details... STATUS
      • FHIR-33201 - Getting issue details... STATUS

        • Add to the header portion of Claim, ClaimResponse and ExplanationOfBenefit

          encounter 0..* Reference(Encounter) The encounters associated with the listed treatments

      • Re-opened FHIR-29687. Motion to re-open 29687. MaryKay McDaniel/Chris Cioffi. 8-0-0.
      • FHIR-29687 disposition is Persuasive with Modification, 
        • The .encounter 0..* Reference (Encounter) has been added under a previous ticket.
        • This ticket suggests a definition of:  Medical Encounters related to this Claim
        • The definition shall be amended to: Healthcare encounters related to this claim
        • The short description shall be amended to:  The encounters associated with the listed treatments
        • Motion to approve with the proposed disposition. Chris Cioffi/Mark Scrimshire. 8-0-0
        • 2/24/2023. Complete - applied
        • 2/28/2023. QA'd. Resolution = Applied to 29687, 30337, and 33201.

• FHIR-27109    Coverage.class value set needs to change "plan" to "benefit plan" - VOCAB UPDATE

  • From SEP 2022 WGM Meeting minutes:  FHIR-27109 - Change "Plan" to "Benefit Plan", not an FM ticket
  • 10/7/2022. This is an FM Ticket, it s a terminology change that needs to be made. Change to the display name. This is in THO, FM needs to create a ticket and make update. 
• FHIR-23003. Remove IP covered codes - Revenue Codes & Present on Admission
  • Re-Open. To apply changes only to the the revenue code center . Motion to re-open. Mark Scrimshire/Chris Cioffi. 8-0-0.
  • New disposition will change the revenue codes and leave the present on admission codes as is. Both are example code systems.
  • Motion to approve, Persuasive with Modification. MaryKay McDaniel/Chris Cioffi 7-0-0.
• FHIR-22763.  Remove invalid icd-10 code references for Claim in valueset-icd-10 and fix codes in related examples. 12/13/2022. MARKED AS CHANGE APPLIED.
  • ticket is marked as resolved - change required
  • Reviewed the code system and the examples. Unable to locate any changes needed.
  • Marked as applied. 
• FHIR-22689. Claim.provider definition is confusing.
  • Will apply the change
  • 2/24/2023. Complete - applied
  • 2/28/2023. QA'd. Resolution = Applied
    • changed to ClaimResponse.requestor (there isn't a provider here, but the words were the same and therefore changed)
    • CoverageEligibilityResponse.requestor did not get changed. Paul will update. 

2/7/2023:  the following tickets are complete with the exception of the code set/value system.

• FHIR-32762. Add dates at the .item levels in Claim Respose and EOB. Listed as duplicate of 22662 another ticket. 

• • 1/10/2023. This is not a duplicate of 22662.  "unduplicated" the ticket. 
  • This is a partial duplicate of 22662. When adding the preAuthPeriod element from 32762, this request will be met.
  • Motion to approve. MaryKay McDaniel/Celine Lefebvre. 5-0-0
  • 2/7/2023. reviewOutcome, need new code system/value set for the .reviewOutcome.reason - we have an external code system but it is not in FHIR or in THO. because we can't, need to make one up. 

    • New example code system/ value set (see table to the left for code | display | description

      • Not medically necessary
      • Prior Authorization was not obtained
      • Provider out of network
      • Service inconsistent with patient age
      • Benefit limits exceeded
    • Paul will add the code system/value set to FHIR to complete these three tickets
  • 2/14/2023: Will add codes and descriptions to the above display values.
  • 2/21/2023 Applied - Complete!!:  reviewed the changes (see the new code list on the left from 2/14/2023)
    • Claim Adjudication Decision Reason Codes v5.0.0-cibuild

• FHIR-22662. Need outcome/disposition/preAuthRef/preAuthPeriod on individual items
  • 12/13/2022. Paul will find competing ticket that added decision element - FHIR-37662 (which is marked as duplicate).
  • Need to go back and refresh.
  • 1/10/2023. 4 items to be added to ClaimResponse/EOB - outcome/disposition/preAuthRef/preAuthPeriod elements to be added at all the .xx levels
    • outcome - the outcome of the processing - The completeness of the processing. believe it should be decision instead (denied, pended, partial, approved) - decision is a perspective of the adjudication "the result of the adjudication"
    • disposition - human readable description of the adjudication status.
    • preAuthRef - at the 'header' level, move down to the .xx levels 
    • preAuthPeriod elements - at the 'header' level, move down to the .xx levels 
    • this ticket was voted 20-0-2, to open back up will take 13 people
    • add a new ticket FHIR-40082  Add cardinalities, value set and rename category to decision in .reviewOutcome
  • 2/21/2023. Applied - Complete. 
• FHIR-40082. Add cardinalities, value set and rename category to decision in .reviewOutcome
  • motion to approve. MaryKay McDaniel/Celine Lefebvre. 5-0-0
  • 2/21/2023. Complete - applied
• This is Done....   Financial Management - 13.0.16 Terminology.

Currently: 

• • • In many cases an example valueset has been provided in this release. Financial Management will be devoting effort in the preparation to Release 5 of FHIR to develop more representative example sets and to determine where global codesets exist such that some of the valuesets may be elevated in strength to extensible or required.

Start here 2/7/2023:

• Ticket for PaymentNotice:  - FHIR-40448

• • • 2/7/2023: Chris Cioffi will create a ticket for all three of these changes 
      • Typo:  Add ticket to correct the description for .identifier, see last word
      • Payment becomes 0..1
      • There is no place to include the 'sender/reporter' on the PaymentNotice. Rename of the "provider field" to reporter. change description to 'entity reporting payment'
      • Motion to approve updates. MaryKay McDaniel / Chris Cioffi 7-0-1
      • 2/24/2023. Complete - applied
      • 2/28/2023. QA'd. Resolution = Applied

Start here 2/14/2023:

• FHIR-22659. PA claims for procedures need a reference to a to a ServiceRequest
  • 1/10/2023:  add all "requests' at the .item level with instruction/discussion on put it there and not in .procedures (procedures can only be 'done' - see Procedure Resource).
    • Device Request
    • Medication Request
    • Nutrition Order
      • A request to supply a diet, formula feeding (enteral) or oral nutritional supplement to a patient/resident.
    • Service Request
      • A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.
    • Supply Request
      • The scope of the SupplyRequest resource is for recording the request of supplies used in the healthcare process. This includes supplies specifically used in the treatment of patients as well as supply movement within an institution (transport a set of supplies from materials management to a service unit (nurse station). This resource does not include the provisioning of transportation services
    • VisionPrescription Resource
  • 2/7/2023. Agreed, need to add. 
    • What would the element that is being added be named?????
    • In what resource are surgical procedures included?
  • 14-Feb-23: Added VisionPrescription
    • This is going to be put into the disposition
    • Motion to approve re-open this ticket and update the resolution
      • MaryKay McDaniel / Rachel Foerster - 7 0 0 APPROVED
      • 2/24/2023. Complete - applied
      • 2/28/2023. QA'd. Resolution = Applied
• [FHIR-37588] Add adjudication quantity to ClaimResponse & EOB - Jira (hl7.org)
  • Group suggested changing the datatype and the name of the existing value (decimal 0..1) to adjudication.quantity  0..1 to allow for the expression of units with a 'type' for clarity
  • description: Non-monetary amount
  • Non-persusuave, enhancement,
  • Motion to approve 37588: 
    • Chris Cioffi, Mark Scrimshire. 14-0-0
    • 2/24/2023. Complete - applied
    • 2/28/2023. QA'd. Resolution = Applied
• FHIR-38627 [FHIR-38627] Clarify use of Coverage.subscriber - Jira (hl7.org)

• • 14-Feb-23 - resolution previously approved
  • 2/24/2023. Complete - applied
  • 2/28/2023. QA'd. Resolution = Applied
  • Need to fix: in comments "not" needs to be no
  • 

•  FHIR-31368    Add guarantor responsibility and related elements to Account
  
  • From SEP 2022 WGM Meeting minutes: FHIR-31368 - Add elements to Account - will discuss in Q1 on Thursday, needs a vote.  Approved 11 Oct 2022 
  • 14-Feb-23 - Waiting for this to be applied
  • 2/28/2023. Changes were not applied
• FHIR-38895  :  Missing invariants from ticket 32076

• 14-Feb-23 - waiting to be applied
• 2/28/2023. Technical error. will deal with it in QA

• FHIR-38896:  Updates to Vocabulary. 

• • Revmove the self-pay code system
  • Change to VS Coverage Type and Self-Pay Codes - Update the Name and title to remove 'self-pay'
  • 14-Feb-23 - this needs to go through the UP process

• [FHIR-37828] Add .payment backbone to .item (EOB) - Jira (hl7.org):  Need to review and approve in WG

• • 8/16/2022 FM Meeting minutes, FHIR-37828: Passed, too time consuming. If we have time will address 8/30.

  • 8/30/2022. Ran out of time
  • 10/11/2022: Ran out of time, add to ballot negative comment
  • 14-Feb-23:
    • There can be differences between benefit amount and payment amount
    • Ran out of time
    • Probably cannot get this in for R5, will create an extension in the interim

Need to create a ticket or negative ballot comment for this clarification:

R4 comments guidance and update for R5

2/21/2023:  Added FHIR-40502

• • Proposed disposition, persuasive. 
  • Motion to approve MaryKay McDaniel / Chris Cioffi 6-0-0
  • 2/24/2023. Complete - applied
  • 2/28/2023. QA'd. Resolution = Applied

• • ExplanationOfBenefit.created

Definition:  The date this resource was created

Requirements:  Need to record a timestamp for used by both the recipient and the issuer

• • • • the definition and the comments don't seem to make sense.
      • Is it the date the resource was created?

12/13/2022. 

FHIR 29687 Motion to edit to definition and change short description. Vote: Mary Kay/Chris Cioffi 8– 0–0

Link following three tickets - FHIR 33201, FHIR 30337, FHIR-29687 Vote: Chris Cioffi/Mark Scrimshire 8–0–0

FHIR 23003 Motion to change ex-revenue codes to be made up values to remove infringement. Vote: Chris Cioffi/Mark Scrimshire seconded 8–0–0. Then motion to change ticket to non substantive. Vote: Mary Kay/Chris Cioffi 7-0-0

FHIR 22763 – No objection to change as applied.

FHIR 22689 – No objection to change as applied.

FHIR 22662 – Already looked at this ticket and agreed to the change.  

FHIR 32762 (marked as duplicate of 22662 but that is not accurate)

1/10/2023.

Anyone in addition to Paul available to make changes to the standard?  Need 1) full build software on machine, 2) access to github and 3) know how to make the changes. 

• base changes made (spreadsheet and structure definitions)
• examples

What are the latest dates for R5?

• "release of R5" May 2023
• Whatever we have in by the end of March

SEE notes to the left for the tickets that were worked on under 1/10/2023 section.

2/7/2023, reviewed in call

See notes in-line to the left....

2/14/2023

2/21/2023

Applied - Reviewed - Complete:

• FHIR-32762
• FHIR-22662
• FHIR-37594
• FHIR-32797
• FHIR-32776
• FHIR-32075
• **the rest need to be spplied by Friday 2/24/2023.

Created FHIR-40502 (last item on the left). update definition and requirement for EOB.created.

• • Proposed disposition, persuasive. 
  • Motion to approve MaryKay McDaniel / Chris Cioffi 6-0-0

Vision Prescription:

• • Proposal to move from FM to OO. OO manages all 'orders'
  • OO has agreed to accept the resource, no intention to remove it
  • This will break implementations, if it is removed
  • No harm in moving this to OO
  • Will discuss further next week

14-Feb-23 -Chris still needs to create ticket 

14-Feb-23  - See notes inline

2/28/2023.

• build.fhir.org/diff.html will get you to a differential page.
• QA'd the changes made, notes in-line of the tickets. 

Paul will followup on the following:

• FHIR-31061    Add a resource level error.
  • 12/6/2022. RE-Open Ticket to remove, "Add a resource level error for an error that applies to the overall resource."
  • Motion to re-open. Chris Cioffi / Jeff Brown. 8-0-0
  • Remove the 1st disposition, "Add a resource level error for an error that applies to the overall resource."  Leaving the rest of the disposition
  • Motion to approve the new disposition. Chris Cioffi / Mary Kay McDaniel. 7-0-2
  • Will update
  • 2/24/2023. Complete - applied
  • 2/28/2023. QA'd. 
    • on claim response and eligibility response - NOT on EOB
    • Complete error structure needs to be added on the EOB Resource!!!!
• FHIR-22689. Claim.provider definition is confusing.
  • Will apply the change
  • 2/24/2023. Complete - applied
  • 2/28/2023. QA'd. Resolution = Applied
    • changed to ClaimResponse.requestor (there isn't a provider here, but the words were the same and therefore changed)
    • CoverageEligibilityResponse.requestor did not get changed. Paul will update. 
• FHIR-38627 [FHIR-38627] Clarify use of Coverage.subscriber - Jira (hl7.org)
  • 14-Feb-23 - resolution previously approved
  • 2/24/2023. Complete - applied
  • 2/28/2023. QA'd. Resolution = Applied
  • Need to fix: in comments "not" needs to be no
  • 
• FHIR-31368    Add guarantor responsibility and related elements to Account
  
  • From SEP 2022 WGM Meeting minutes: FHIR-31368 - Add elements to Account - will discuss in Q1 on Thursday, needs a vote.  Approved 11 Oct 2022 
  • 14-Feb-23 - Waiting for this to be applied
  • 2/28/2023. Changes were not applied
  • Paul will check to see if it can be added in QA period
• FHIR-38895  :  Missing invariants from ticket 32076
  • 14-Feb-23 - waiting to be applied
  • 2/28/2023. Technical error. will deal with it in QA 

VOCABULARY:    New Code System needed for Surface Codes: 

Existing:  HL7.TERMINOLOGY\Surface Codes - FHIR v4.0.1

CREATE a new Code System

• FHIR-34221
  • 12/6/2022. THO changes. 
  • The value set is an example value set
  • Must go through THO

1. Create a new code system

• • • with the values below and add F, Facial, The surface of a tooth facing the lips.
    • Yes there are 2 codes with the same definition. F is used in the US only, V is used in all other countries.
      • Countries that follow ISO or FDI use "V"
      • 

2.  Create a US value set that inclues all except the "V"

3.  Create a FDI value set that inclues all except the "F"

4. The existing code system will then be deprecated

5. will there need to be a naming system entry created? Question for Vocab

• • research OIDS
    • http://terminology.hl7.org/CodeSystem/FDI-surface  OID is:  urn:oid:2.16.840.1.113883.4.642.1.1154

Create new Value Sets:

existing EXAMPLE VS:  HL7.TERMINOLOGY\Surface Codes - FHIR v4.0.1   URL:  http://terminology.hl7.org/ValueSet/surface  urn:oid:2.16.840.1.113883.4.642.3.546

From ADA Standard No 1084_May2019.pdf:   Surface Code (2.16.840.1.113883.4.642.1.316)

From the OID registry:  

From the new V2+ web version:

HL7.TERMINOLOGY\bodySiteModifier - FHIR v4.0.1  Official URL: http://terminology.hl7.org/CodeSystem/v2-0495

11/1/2022:

See FHIR-33202. Another ADA code system (tooth identifying system). Add to THO

Jeff reaching out to Rick for an update.

Paul - we can do a better job for example codesets, especially in places where each country may have their own codeset. (IE Billing codes) where the codesets can vary widely.

We are working on value sets in improving definitions for interoperability. Targetting R6 for that cleanup.

VOCABULARY:  Coverage.type

Steps: 

• Review each resource (alphabetically)
• Identify each vocabulary that needs to be updated

Replacing the v3 ActCoverageTypeCode Value Set

***We have SEVERAL R5 tickets around this value set:  13024, 14127, 24916, 20361  (these are linked and in FMWG-Discussion Grouping)

VOCABULARY:  General

C/N Working List of Definitions - Financial Management - Confluence (hl7.org)

See also JAN WGM work:  2022 01 20 Thurs Q3 - FM WGM Minutes - Financial Management - Confluence (hl7.org)

11/15/2022: FYI, 

R5 Work - Clarification ADJ Category vs. ADJ Reason... what is the difference between Category and Reason use

PaymentReconciliation - add a ticket to request documentation addition to describe how to do a refund.

6/28/2022: 

Category = Large Bucket

Reason = further description of why something ended up in the bucket

Potential EXAMPLES:

Category:  Patient Responsibility  / Reason:  Deductible / Amount:  256.00

Category:  Patient Responsibility / Reason: Co-Pay Amount / Amount: xx.xx

Category:  Patient Responsibility / Reason: Co-Insurance Amount / Amount: xx.xx / Value:  .20

Category:  Patient Responsibility / Reason: Non-Par Provider

Category:  Contractual / Reason: exceeds fee schedule / Amount: 27.00

Category: Contractual / Reason:  exceeds plan contractual / Amount / 98.00

Category:  Contractual / Reason: POS step down amount / Amount: 11.00

Category:  Other / Reason: Tax Not Covered / Amount: 33.45

Category:  Other / Reason: 

Category:  Constractual / Reason: exact dup claim/service 

Category:  Payer Initiated Reductions / Reason:  Performance program proficiency requirements not met / Amount

01-Nov-22: The US has unique requirements. There's a desire to see how we can synchronize international code usage, as much as possible.

There are also situations where different jurisdictions have elements with the same name, but different meaninging.

supportingInfo Slices in existing IGs:

CARINBB:

• Billingnetworkcontractingstatus
• admissionperiod
• clmrecvdate
• typeofbill
• pointoforigin
• admtype
• discharge-status
• drg
• medicalrecordnumber
• patientaccountnumber
• benefitpaymentstatus
• dayssupply
• dawcode
• refillNum
• refillsAuthorized
• brandgenericindicator
• rxoriginCode
• compoundcode
• performingnetworkcontractingstatus
• servicefacility

PAS:

• PatientEvent
• AdmissionDates
• DischargeDates
• AdditionalInformation
• MessageText
• InstitutionalEncounter (information about a hospital claim being requested)

VA:

• Initial Placement (dental claim)

Do we need to add any of these to the base?

01-Nov-22: We might add to base is to guide IG authors in the best practice for adding this data.

CARIN made the design desicion to NOT use any extensions, and so they are using supportingInfo slices. Other IGs are using extensions for the same data elements. We'd like to simplify this for implementers with a standard.

HL7 Antitrust Policy - Updated 10/2021

• The HL7 Antitrust Policy was approved as part of the last GOM Revision
  • Section 05 Antitrust Compliance
• The following statement must be added to the minutes for each meeting:
  • Professional Associations, such as HL7, which brihng together competing entities are subject to strict scrutiny under applicable antitrust laws. HL7 recognizes that the antitrust lawas were enacted to promote fairness in completion and, as such, supports laws agains monoploy and restraints of trade and their enforcement. Each individual participating in HL7 meetings and conferences, regardless of venue, is responsible for knowing the contents of and adhering to the HL7 Antitrust Policy as stated in 05.01 of the Governance and Operations Manual (GOM).
• Co-Chair Handbook has been updated:  Co-Chair Handbook - Co-Chair Handbook - Confluence (hl7.org)

HL7 Code of Conduct

HL7 is a community where we can always ask searching questions about technical matters and how our decisions might impact our various communities and stakeholders, but HL7 and its participants are committed to a harassment-free environment for everyone, regardless of level of experience, professional background, gender, gender identity and expression, sexual orientation, disability, personal appearance, body size, race, ethnicity, age, religion, or nationality. Generally this should mean there is no reason for those subjects to come up with regard to any specific individual.

Co-chairs are asking our WG participants periodically review the HL7 Code of Conduct .

FM Co-Sponsoring:

Human Services WG:

• Project Proposal review:  [PSS-2000] FHIR IG for the Human Service Resource and Provider Directories - Jira (hl7.org)

3/29/2022:   Motion that FM be a co-sponsor.   Approved. 16-0-0

Da Vinci:

• Burden Reduction IGs - CRD STU2 - 
  • FM Primary Sponsor
• Burden Reduction IGs – PAS STU2 
  • • FM Primary Sponsor
• PDex STU2
  • FM Primary Sponsor
• Patient List
  • FM Sponsor
  • Risk Adjustment - Da Vinci - Confluence (hl7.org)
  • PSS:  PSS for Risk Based Contract Member Identification (Updated) - Financial Management - Confluence (hl7.org)
• National Directory (we are co-sponsors):  HL7.FHIR.US.FHIR-DIRECTORY-EXCHANGE\Home - FHIR v4.0.1
  • PA Sponsor
  • FM/PIE Co-sponsors

Primary Sponsor:

• KSA
• DV CRD
• DV PAS
• DV PDex
• DV Patient Cost Transparency 
• DV PCDE
• DV Member Attribution
• DV Plan Net
• CARIN for Blue Button

Co-Sponsor:

• National Directory (w/ PA)
• Gender Harmony (w/Vocabulary)
• CARIN Digital ID Card (w/PIE)
• DAM UDI (w/O&O)
• Validated Healthcare Directory R1 (w/PA)
• Human Service Resource and Provider Directories (w/Human Resources)

Withdrawn (FM was sponsoring):

• V3 Accounting & Billing R2
• V3 Claims and Reimbursement R4

Miscellaneous

• Uniform Elements for Prior Authorization