Page History

Greg Meyer

Joseph Shook 

2023-01-23 National Directory Meeting

Project Page: National Healthcare Directory

Project Scope Statement: National Healthcare Directory PSS

Implementation Guides:

• CI Build: http://build.fhir.org/ig/HL7/fhir-us-ndh/branches/master/index.html
  • Note: 3 IGs have been combined into a single IG
• Balloted Versions:
  • http://hl7.org/fhir/us/directory-query/2022Sep/
  • http://hl7.org/fhir/us/directory-exchange/2022Sep/
  • http://hl7.org/fhir/us/directory-attestation/2022Sep/

Connectathon: 2023- 01 FAST National Directory of Healthcare & Da Vinci Plan Net

Zulip Channel: https://chat.fhir.org/#narrow/stream/283066-united-states.2Fnational.20directory

Predecessor work that this effort builds upon:

• • VHDir Implementation Guide
  • ONC Healthcare Directory initiative
  • Da Vinci PDex Plan Net Implementation Guide

Sept 2022 Ballot Cycle Milestones

Tentative: May 2023 Ballot Cycle Milestones

CMS Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule (CMS-0057-P)

• Federal Register (officially published 12/13/22)
• Fact Sheet
• Comment period closes 3/13/2023

This proposed regulation cover areas like Patient Access API, Payer to Payer Exchange, Handling Prior Authorization, etc.

Administrative Simplification: Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction Standard Proposed Rule (CMS-0053-P)

• Federal Register (published on 12/21/22)
• Comments due 3/21/23

This is the long awaited attachments rule from the Division of National Standards. It contains follow on requirements in the Accountable Care Act that mandated that CMS establish a standard for exchange of attachments compatible with HIPAA transactions. 

• Relates to FHIR-38362
• Resolution: persuasive with modification
• Change category: Clarification
• Change impact: non-substantive
• Grouping: ready for vote

FHIR-38619 Expand on the terminology section

• Going to have to write up something much broader. 
• Resolution: persuasive
• Description: update the combined IG with a more robust treatment of terminology and value sets
• Change category: clarification
• Change impact: non-substantive
• Grouping: ready for vote

FHIR-38611 Expand description of subscription exchange method

• Going to have do this
• Resolution: Persuasive
• Description: Will expand the description of subscription to include workflow diagrams, handling of deactivated records,  methods of alerting, and methods of exchange of data in the combined IG
• Change category: clarification
• Change impact: compatible, substantive
• Grouping: ready for vote

FHIR-38610 Correct numbering and changing titles

• Resolution: persuasive with modification
• Description: Will ensure that the combined IG has clear section titles and numbering
• Change category: Correction
• Change impact: Non-substantive
• Grouping: ready for vote

FHIR-38608 Add system flow diagrams to exchange methods

• Resolution: persuasive 
• Description: Will add flow diagram(s) to section on methods of exchange
• Change category: Clarification
• Change impact: Non-substantive
• Grouping: ready for vote

FHIR-38620 Correct endpoint capability statement reference

• Resolution: Persuasive 
• Description: Will correct the profile and link to the endpoint profile(s) in the combined IG
• Change category: Correction
• Change impact: Non-substantive
• Grouping: ready for vote

FHIR-38074 Allow direct reference form insurance plan to organization - "network" concept does not exist for all payers

• Suggest we provide guidance on this one vs. create new construct; trying to connect one to many whereas we connect many to one; it's untenable and we are taking one of his suggestions
• Resolution: Persuasive with modification
• Description: The current network structure will work for the situation you described by creating a single network that is pointed to by the insuranceplan.network reference and using the ability of practitionerRole and OrganziationAffiliation to indicate participation in the network. We will provide guidance in the combined IG to describe this solution for the situation you have noted. 
• Change category: Clarification
• Change impact: Non-substantive
• Grouping: ready for vote

JL: