Chair: Mark Scrimshire
Scribe: Vanessa Candelora
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."
Minutes Approved as Presented
Meeting Minutes from Discussion
|Decision Link(if not child)|
|Management||Review ANSI Anti-Trust Policy|
Call Structure & Name Changes
See Supporting section below!
Registration is now available here
Early Bird registration August 16th and last day to register is August 30th.
|Formulary: Quick Update on Drug Search (include Pack) - 5min|
If you put dose form groups into the index that is searched then they will find it and link to the thing on the formulary. Who is responsible for doing that? In the index that is searched (doesn't make sense to RM)
Are there strings in the names of these drugs that would show up in one of the RX norms
Semantic Drug Form
The packs get more complicated that could have different forms.
Define who will be responsible to sharing alternatives.
Rob feels strongly that server's job (not the searcher) should be resonsible for sharing the alternatives based on ingredient. More detailed notes on this here: 2021-07-02 Payer Data Exchange (PDex/Formulary/PlanNet) Implementer Support Meeting
|New Implementer Support / Question - 10min|
Plan Net question from Zulip - if not previously answered/still open concern: https://chat.fhir.org/#narrow/stream/229922-Da.2BVinci.2BPDex.2BPlan-Net/topic/InsurancePlan.2Eplan.2Etype
Reviewed and discussed.
Product vs. Plan.
Medicare Advantage is a product. then Plans are underneath.
For Medicare and others, their is high and low deductible. These 5 codes are standard based on the exchange. It was agreed that this would cover the basis. They are not going to map anything to these since it's not the same for Medicare.
Proposed Action: Add some language to the definition to make it explicit in the code system for what to use for the common Products and plans.
Cost sharing issue or different products?
SV: is there a definition for these 3 Medicare tier plans.
SV: none map to medicare
Action Item: Let's go back and get some additional info. Dave will frame the questions and see what response we get to inform next decision. At least, let's clarify with language and an example for Medicare, we may want to make changes to IG as well.
PDex: Provenance Profile in Correction Needed to Recorded
Need to update Text Description of Provenance Recorded - "Timestamp when the activity was recorded or updated." Revert to US definition for Recorded.
Will also be updating the FAQ #14 to align how this works.
Ticket in JIRA: https://jira.hl7.org/projects/FHIR/issues/FHIR-33141
Likely a technical correction process with HL7 to update the IG.
Discussion on the FAQ #14 - Second paragraph of A.
Mark proposed clarification to address Dan's concern ,
|Next Week (Potential topics)|
Review FAQ Proposed Responses
Plan Net Feedback- DaVinci Plan Net (Directory) STU Balloting Dashboard - In the coming weeks, we'll begin reviewing open JIRA Trackers that may help implementers.
|Address on 8/13|
PDex: $everything on Patient and Bulk
We've heard some confusion around using $everything on patient and using bulk and how the provenance needs come into this.
We want to clarify what the $everything on Patient means.
|Address on 8/13|
Plan Net Open Tickets Review
Adjourned at 1pm EST.
|PDex Companion Guides|
|CARIN CPCDS to US Core Mapping|
Latest draft CARIN CPCDS Mapping document: CARIN Mapping to FHIR interim 2020 0818 v2.xlsx
DRAFT - PDEX US Core Mapping from CPCDS source: ResourceMappingUSCoreCPCDS-2020-05-29-v26.xlsx
|PDex - US Core |
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
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!
ONC FAST National Healthcare Directory (including end points) solution page that includes links to everything (solution doc, Connectathon, HL7 workgroup, etc.): https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/National+Healthcare+Directory
For questions, reach out to us on Zulip:
- David Hill - Dave will get more clarity on https://chat.fhir.org/#narrow/stream/229922-Da.2BVinci.2BPDex.2BPlan-Net/topic/InsurancePlan.2Eplan.2Etype . May need some or all: clarifying language, A written example for Medicare, changes to IG.
- Mark Scrimshire - Mark and Bob work offline on the FAQ #14 to address Dan's concern .
Attendees - 25
Intepro Solutions Rakesh Mathew Daniel Lilavois Patricia R Harbin Shalabh Gautam Kamaraj Kaliaperumal, Carefirst Bhanu Vemuri Narasimha Murthy Accenture Maggie Mellon Courtney Bland
Present Name Affiliation MITRE HealthLX MITRE Evernorth Mettle Solutions Rachel E. Foerster BCBST Tom Grannan Azuba Vanessa Candelora POCP, Da Vinci PMO Deepthi Reddy Mettle Solutions Allscripts Eric Sullivan Inovalon 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 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 Jim Catan Accenture BCBSA Jia Chen Jeff Eastman Ernestine Cooper Jason Teeple CIGNA Mary Winter 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 Fred Harmon Ready Computing Blue Cross NC Michael Ryan NCQA HealthSparq CVS/Aetna Dorothy Lee NCQA Khoa Nguyen Suma Addagadde BCBSNC Caitlyn Campi FL Blue Diane Bengtson Sean Mahoney MITRE Balaji Richard Lisseveld Shanna Hartman CMS Kevin Day Edifecs Sai Bagewadi Cognizant Kechia Scott Kerri Wing Krithika Kumar Accenture Don Zacharia Pamela Maklari Cognizant @David Bradsher BenMedica @DJ Gallagher @Follis @Nidhi @Emily Lozada Bruce Schreiber Ed Hafner WEDI / Change Healthcare Alberto S. Llanes FEHRM Danny Iacovou Kimberly Bradbury Prime
Patricia R Harbin
Chris Johnson Anthony Omosule Accenture Google Cloud Healthcare Independent Health Scott M. Robertson David Clowers
Present Name Affiliation Nancy Spector AMA Bruce Wilkinson BenMedica Avality Daniel Venton Optum BCBSAL Rob McClure MD Partners Ronald Wampler CVS Health Aetna Bryan Briegal ACP @Callie Phillips MCG ONC Surescripts NCPDP Anupam Thakur BCBSFL Jonathan Hutchins BCBST Anthem Sunitha Godavarthi Christopher Gracon 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 Ezequiel Morales Cigna Evernorth Frank McKinney Hanna ? Brett Rauschke Carolyn McKinney Clarissa Winchester BCBS AL JC HealthShare Exchange (HSX) River Wong 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 Beatrice Thompson CVS Health Hema Srinivasa Kristin Ashby Aetna Nag Sanivarapu Abhishek Pandey Shailesh Prabhu Travis Hendrix Dr. First Zakir Guler Jason VanderJagt edifecs Erika Wagner Shamil Nizamov Michael Robinson Christopher Marchand Chris Busch Nathaniel Hosenpud Christopher Roedocker SKYGEN Jeff Brown MITRE Sid Nehal Amin Amit Cudykier C45214 Noah Lincoff Yukta Bellani Evernorth/Cigna Brian Schoonover Optum Tone Southerland OneRecord @Ram Optum Kat Sobel NCQA Phung Matthews Benji Graham @Grace Stambaugh Donnielle Williams Rob Brull Eric Liu, PharmD, MBA
Google Cloud Healthcare
Scott M. Robertson