Short Description

Real-world testing of the CARIN Consumer Directed Payer Data Exchange (CARIN IG For Blue Button®), which provides a set of resources that payers can display to consumers via a FHIR API, including Oral and Vision Profiles.

Long Description

The CARIN Alliance is an HL7 FHIR Accelerator program which brings implementers together to advance the use of HL7 FHIR standards in health care. The CARIN Alliance Health Plan Workgroup was organized to develop a FHIR-based API that could be sent to a consumer-facing application and was designed to answer the challenge for health plans to ‘meet or exceed’ the CMS Medicare Blue Button 2.0 capabilities. The CMS Medicare Blue Button 2.0 project provides over 53 million Medicare fee-for-service beneficiaries access to their electronic claims information.

The CARIN Consumer Directed Payer Data Exchange Implementation Guide (CARIN IG For Blue Button®)  was balloted in January for STU2 and comments are currently being addressed and resolved. Updates to the IG are being made to the continuous build once voted on and approved by the HL7 Financial Management Work Group.

The objectives of this track are: 

  • Test and gather feedback on the Draft Implementation Guide V2.0
  • Test the Oral and Vision Profiles
  • Utilize the Aegis Touchstone Testscripts to identify gaps or errors

Evolution of Patient Access to Claims Data Related to the CARIN IG for Blue Button®


Blue Button 2.0 API

  • The Blue Button 2.0 API is a FHIR R4, developer-friendly, standards-based API that enables Medicare 
    beneficiaries to connect their claims data to applications, services and research programs they trust.
  • The API offers the following FHIR resources on a beneficiary-by-beneficiary basis:
    • Explanation of Benefit
    • Patient
    • Coverage
  • To access their data, beneficiaries must download a 3rd party application, then authorize the app to 
    retrive their data. Beneficiaries can revoke access at any time via or by contacting the 
    3rd party application.
  • The Blue Button 2.0 API conforms to the CARIN Blue Button IG STU1 (See below)
  • The team that develops the API and manages production app access is a part of the Data Analytics 
    and Strategy Group (DASG) under the Office of Enterprise Data and Analytics (OEDA) at CMS. 

If you would like to learn more about the Blue Button 2.0 API - a publicly available FHIR R4 API that provides coverage and claims data for Medicare beneficiaries. Please visit the track page here: CMS 2022 - 07 Blue Button 2.0 API Introduction and Workshop


Test an Implementation Guide

Track Prerequisites

Knowledge of USCore

Track Lead(s)

Track Lead Email(s),

Specification Information

CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®) (PSS, STU1, Draft STU2)

Call for participants

Payers and consumer-facing apps

Zulip stream

Track Kick off Call

September 14, 2022 at 1 pm ET

Meeting ID: 973 2224 2408

Passcode: HL7Fhir#

Track kickoff call slides and information below. The recording option wasn't available. 

Clinical Input Required?
Related Tracks?

Testing Scenario:

In advance of the Connectathon we would ask participants to attend the Implementers Connection Calls and have signed up for the track ahead of the deadline. It is critical to attend the calls and sign up by the deadline as we will be matching Clients and Servers to ensure that everyone has someone to test the below Scenario.

We also ask that in advance of the testing session all participants onboard with the free Aegis Touchstone Testscripts. The below Powerpoint will guide you through the onboarding process. If you run into any issues, please reach out directly to Aegis at

These Testscripts are critical to ensuring that all participants are following a similar pattern when implementing the CARIN IG for Blue Button.


Scenario: Sandbox user retrieves EOBs from the Sandbox server using the Client

  • Action: Sandbox user receives the access and refresh tokens from the Sandbox server and calls the EOB endpoint
  • Precondition: Sandbox user is logged into the Client
  • Success Criteria #1: The server returns resources that are compliant with CARIN BB Profiles, including Vision and Oral EoBs
  • Success Criteria #2: Server is compliant with SMART App Launch [Stand alone mode] framework
  • Success Criteria #3: Register with Aegis and utilize the Touchstone test scripts
  • Bonus point #1: On expiration of the access token, the app uses the refresh token to get new access and refresh tokens
  • Bonus point #2: The Server exposes search criteria (link) for selecting the EOBs and the client uses search parameters to select and retrieve the EOBs.
  • Bonus point #3: For a Server supporting _include, the resource instance included in the search response should match the instance from a separate read/vread on that resource's reference.

Test Script(s): Aegis Touchstone

1 Comment

  1. For those interested in using the Touchstone Proxy feature, please watch the following videos:

    VIDEO 1: FHIR Testing - Using Touchstone's Peer-to-Peer/Proxy Features to Capture and Test FHIR Exchanges ( 2: FHIR Test Server Setup for Peer-to-Peer/Proxy Testing in Touchstone & Connectathon Manager (ConMan) (

    Set up and walk-through of AEGIS's Touchstone Testing Platform operating as a proxy using the Peer-to-Peer feature to test and capture FHIR exchanges between a client and server with and without OAuth by Richard Ettema, Lead Developer and Sr. Technical Architect, AEGIS’ Touchstone Testing Platform.

    High-level walk-through of FHIR Test Server set up and configuration using AEGIS' Touchstone Testing Platform and where to find the proxy data used in Conman Connectathon Manager to advertise the proxy connection for Peer-to-Peer/Proxy Testing by FHIR Clients at HL7 FHIR Connectathons and related events, by Wendy Gereke, Engagement Manager, AEGIS’, Inc.