Page tree

Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.

...

Section

Attendees

Column


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



Column


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



...

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

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



Connectathon Kick-Offs (PDex, PDex Formulary, PDex Directory)PDex Ballot Comment Review
  • PDex Formulary: 2019-09 DaVinci PDEX Drug Formulary
  • PDex Directory: 2019-09 DaVinci PDEX Plan-Net
  • PDex: 2019-09 Da Vinci Payer Data Exchange
    • PDex Plan Net questions
      • Requirement in the IG is to show a network for a plan, is this showing data across plans?
        • RI lets you browse all the data on that server - you could pick a plan and pick a network and constrain it
        • If payer provides network information for Medicare Advantage plan, then there's only one payer and one plan
        • Still would need a definition of the payer and the network in the server, but you wouldn't need to select the payer - there would only be one
      • How are you getting the list of plans? 
        • RI is querying all the organizations that are labeled as payers
        • When go to find networks, looking for networks whose managing organization is related to that payer
      • Is there a page that lists out the important details re: server location, IG, sandbox data?
        • Included in the PPT presentation - will be posted to Confluence
    • PDex
      • PDex Reference Implementation
      • Want to focus on payer to payer data exchange, where member didn't need to authorize exchange
        • How do we identify the member
        • Need to update the RI page with relevant content as we get closer to Connectathon
      • It won't be a member-mediated exchange?
        • IG focused originally on 2 scenarios
          • Provider requesting info about the member - covered under HIPAA treatment and operations provision
          • NPRM added requirement there should be a member-authorized exchange between health plans or to 3rd party app
        • Non-member authorized payer to payer exchange jhas not been addressed in IG yet, but needs to be - CMS OCR put out guidance saying that a payer to payer exchange could be covered under continuity of care/operations provision in HIPAA
          • Plans need to identify the exact member involved to exchange the correct data - this hasn't been tested during Connectathon yet
        • Kathleen Connor chat comment:  Please put the citation to this OCR guidance.  Robert Dieterleto follow up with link.

        • Amol Vyas chat comment:

        • None of the above are covered in HIPAA covered transactions (e.g., X12 835, 278, 270, etc.)
      • Does the guide cover the trust framework, if we're not using OAuth?
        • We may use OAuth system to system, but not using the same OAuth being used for consumer
        • May not be what's in the SMART on FHIR framework
        • This needs to be in the guide - when it was balloted, the timing of the guidance prevented us from addressing this in IG previously


    PDex Ballot Comment Review

    #23289

    • Patients should be able to say don't disclose family history and psychiatric information
    • There are records that already exist and don't have security labels on them
    • At point of disclosure, apply security label
    • 42 CFR and state laws require this
    • Member authorization to disclose/Right of Access
    • This is under the patient-everything section (3-4-3)
    • Need to separate member-authorized vs. non-authorized






    Next Agenda

     Adjournment

    Adjourned at at 1:03pm ET


    Supporting Documents

    Outline Reference

    Supporting Document

    Minute Approval
    Connectathon Kick-Off Recording2019-11-15 PDex-PDex Formulary-PDex Directory_Connectathon Track Overviews.mp4
    Connectathon Kick Off PresentationPresentations
    PDex Companion GuidesPDex IG Companion Guide List




    ...