2002-11-08 PIE WG Meeting Agenda/Minutes

Antitrust Statement

Professional Associations, such as HL7, which bring together competing entities are subject to strict 
scrutiny under applicable antitrust laws. HL7 recognizes that the antitrust laws were enacted to promote 
fairness in competition and, as such, supports laws against monopoly and restraints of trade and their 
enforcement. Each individual participating in HL7 meetings and conferences, regardless of venue, is 
responsible for knowing the contents of and adhering to the HL7 Antitrust Policy as stated in §05.01 of 
the Governance and Operations Manual (GOM).

Approved minutes by consensus.

New Proposals andPSS for revi/ew - PIE comments or interest

Updates

1. Ballot enrollment delayed for 2023 January ballot cycle

Dear voters,

As HL7 staff work through some remaining issues with the new membership system and how it interacts with the ballot desktop, we will need a little more time to ensure we are prepared to open the consensus groups and be responsive to any further issues that may arise. Please bear with us, we expect to open the ballot pools later this week.

Watch your email for the announcement when it is released!

Thanks, Lynn

2. HL7 Process for Publishing a FHIR IG

This is a request for your structured HL7-related responses to an NCVHS Request for Comment (RFC) in advance of the body’s scheduled January 18-19, 2023 full meeting.  HL7 is anticipated to testify. The event focus is listed below and the NCVHS Request for Comment (RFC) published in the Federal Register can be found at:  

https://www.federalregister.gov/documents/2022/11/01/2022-23678/national-committee-on-vital-and-health-statistics-meeting-and-rfc  

Note, the NCVHS submission deadline in response to their Request for Comment is December 15, 2022, well in advance of the January hearing. Therefore, your HL7 comments on this are due to me at tgerber@hl7.org by December 8. Attached here is a response template to make responding easier and streamlined.  

A complete list of questions listed in the RFC is available at: https://ncvhs.hhs.gov/​January-2023-Standards-Subcommittee-Hearing-Public-Comment-Guidelines. 

Click here for the template - Call for Comments - NCVHS X12 and CAQH CORE Proposals

Alix summarized regarding the new X12 and CORE Operating rules.  A request to receive feedback from Accelerators and Workgroups.  Durwin stated that there was an Attachment Operating rule, and Alix commented that until an attachments standard was named in HIPAA, operating rules should not come first.  She thinks PIE needs a formal response since we are the attachments workgroup.  This will be added to the agenda next week to come up with comments to submit.  Use the template to order comments.

High-level description of changes:

• Infrastructure Rule – Weekly system availability changing from 86% to 90%

• Telemedicine – communicate coverage using CMS place of service codes (02 and 10)

• Procedure Codes – respond at procedure level (CPT, HCPCS) for Physical Therapy, Occupational Therapy, Surgery and Imaging

• Service Type Codes – Addition of new discretionary and mandatory service types

• Prior Authorization/Certification – addition of return the value of “N” and also returning at procedure level

• Tiered Benefits – returning more granular level data/details

• Maximum and Remaining Coverage Benefits – 10 service types included

• Patient Attribution Data

https://confluence.hl7.org/display/ATT/2002-11-08+PIE+WG+Meeting+Agenda?preview=/144970112/144970705/NCVHS%2520RFC%2520-%2520Comment%2520Template%2520-%2520November%25207%2520FINAL.docx

PIE is co-sponsor, so we were asked to vote on moving the guide forward so that it can be on Sept 2023 ballot.  Christol motioned that we vote to move the guide forward, Susan seconded the motion.

VOTE:  13-0-0

Decided to use 6020 and 5010 in both 275 columns.  See document link for mapping updates for the following:

7.  Claim/PreAuth/Provider assigned for their claim or PA to payer

8.  Line Item

9.  Loinc Attachment code

10.  Due Date

11.  Date of Service

12.  Member ID

13.  Name

14.  Account No.

15.  Date of Birth

Mapping was completed, so now need to meet with FM workgroup.