Chair: Mark Scrimshire
Scribe: Vanessa Candelora
Create Decision from template
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
Agenda Topics
Agenda Outline | Agenda Item | Meeting Minutes from Discussion | Decision Link(if not child) |
|---|---|---|---|
| Management | Review ANSI Anti-Trust Policy |
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Call Structure & Name Changes |
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| Implementer Resources | See Supporting section below! | ||
| Sept Connectathon | When: 9/13-9/15 Registration is now available here Early Bird registration August 16th and last day to register is August 30th. | ||
| Today | |||
| Formulary: Quick Update on Drug Search (include Pack) - 5min | Formulary STU1.1- Drug name guidance needs to be wrap up. (remember it is an update so provide additional guidance not big changes) Main discussion was on Brand vs generic vs equivalent/alternatives.
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| PlanNet/Directory | Plan Type Issue is on the Plan Type sharing profile- Under insurance plan, we have type, such are medicare,, commercial as product type. Under plan type we have cost sharing, tiers such as platinum, gold.
Challenge: How to manage difference between QHP and non-QHP plan types. Are there other types to add or categorize in a standard way?
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| New Implementer Support / Question - 10min | Question on Zulip: If we have concept of three tiers of medicare plans, premium, select, standard, can these be map to the Platinum, gold, silver. Answer: No, the plan types should follow the QHP definitions | ||
| Next Week (Potential topics) | Implementer Support 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. FHIR-33173 created to track this change. This may be going into STU2 update, wanted to share that this now has a JIRA ticket. | |
| Address on 8/13 | Plan Net Open Tickets Review | 6 NUCC Tickets David Hill Robert Dieterle Review any other open tickets that need discussion to understand the problem or with Proposed Dispositions to review. | |
| Adjournment | Adjourned at 12:50pm EST. | ||
Outline Reference | Supporting Document |
|---|---|
| Minute Approval | |
| 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 inter-relationship |
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 |
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| Other Links: | Source code is here: https://github.com/HL7/davinci-epdx
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Implementer Resources | Da Vinci Implementer Support Page 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! Da Vinci PDex for Patient Access API Frequently Asked Questions (FAQs) CMS Final Rule Questions and Answers log 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: |
Action items
- 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 BlandPresent 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
Chris Johnson Anthony Omosule Accenture Google Cloud Healthcare Independent Health Scott M. Robertson David ClowersPresent 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 Chris Geisler