Facilitator:  Peter Gunter 

other co-chairs attending: Christol Green Chris Johnson 

Scribe: Robin Isgett  


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).

Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link


HL7 ANSI Anti-Trust Policy

HL7 adheres to the ANSI Anti-Trust policy.  We should avoid sharing any information on this call that could be interpreted as anti-competitive.  If there are topics that you don’t normally speak about in other public settings, such as conferences or trade shows, then it’s probably best to save those topics for another time as this is a public call. If you have any questions you can refer to the GOM section 05.01 or consult your companies legal division.

Reviewed Anti-Trust Policy.

 Minutes Approval  - Dec 13, 2022

Minutes approved by consensus.

New Proposals and PSS for review - PIE comments or interest

  1.  No new proposals.
  2. New PSS 2145 - Data Exchange Pharmaceutical Quality dx-PQ.  Commented:  PIE WG reviewed the PSS and is not an interested party at this time.  

Hot off the press

Federal Register RIN 0938-AT38 
Administrative Simplification: Adoption of Standards for Health Care Attachments
Transactions and Electronic Signatures, and Modification to Referral Certification and
Authorization Transaction Standard  (90 day comment period)

The following standards are listed in the NPRM:


  • X12N 275 - Additional Information to Support a Health Care Claim or Encounter (006020X314), September 2014; IBR approved for § 162.2002(d).
  • X12N 275 - Additional Information to Support a Health Care Services Review (006020X316), August 2021; IBR approved for § 162.2002(c).
  • X12N 277 - Health Care Claim Request for Additional Information (006020X313), September 2014; IBR approved for § 162.2002(e).
  • X12N 278 - Health Care Services Request for Review and Response (006020X315), September 2014; IBR approved for § 162.1302(e).
  • HL7 CDA R2 Attachment Implementation Guide: Exchange of C-CDA Based Documents, Release 1 – March 2017; IBR approved for§162.2002(a).
  • HL7 Implementation Guide for CDA Release 2: Consolidated CDA Templates for Clinical Notes (US Realm) Draft Standard for Trial Use Release 2.1, Volume 1— Introductory Material, June 2019 with Errata; IBR approved for §162.2002(b).
  • HL7 Implementation Guide for CDA Release 2: Consolidated CDA Templates for Clinical Notes (US Realm) Draft Standard for Trial Use Release 2.1, Volume 2 — Templates and Supporting Material, June 2019 with Errata; IBR approved for §162.2002(b).

Also, the 278 standard for referral certification and prior authorization are proposed for update:

  • Update from the current 278 (005010X217) to: 278 - Health Care Services Request for Review and Response (006020X315)

In the preamble, continued evaluation and future consideration mention of HL7 FHIR-based standards is outlined with references of prior recommendations from NCVHS and the FHIR Clinical Data Exchange (CDex) IG. See section 3. Alternatives Considered starting on page 63.

Much discussion around the NPRM regarding attachments.  Lenel stated that it was not exactly what was needed.  Stanley stated that at least an attachment rule was started.  Andrea asked if the proposed rule would impact the prior auth NPRM since they seem inconsistent.  Alix referenced a letter to NCVHS and stated that our comments to this NPRM could influence the final rule.  Bob stated that the proposed rule made sense in 2016, but that now there are better alternatives.  Rachel stated that the involved cost and resources may be a factor.  We will have discussions, at length, during the Jan WG meetings.  Participants testifying at the X12 call on Thursday may have input.

2023 Calendar of events

HL7 FHIR Connectathon, Jan. 14-15, 2023, Hilton Hotel Lake, Las Vegas Resort and Spa, Henderson, Nevada

HL7 Working Group Meeting, Jan. 16-20, 2023,  Hilton Hotel Lake, Las Vegas Resort and Spa, Henderson, Nevada

Review Agenda​ https://www.hl7.org/events/

NCVHS Sub-Committee hearing, Washington DC - testimony will be presented

      1/18/2023 X12 8020 proposed rules

      1/19/2023 CAQH CORE proposed rules

 X12 January 22 – Feb 1st – Westminster CO 

VIVE - March 26 - 29, 2023, Nashville TN  https://www.viveevent.com/

40th National HIPAA Summit - Virtual March 7-10, 2023  www.HIPAASummit.com

HIMSS23, April 17-21, 2023, Chicago IL https://www.himss.org/global-conference

HL7 Connectathon and WGM

NCPDP 2023 Annual Technology & Business Conference, May 8 - 10, 2023, Scottsdale, Arizona, https://ncpdp.org/ac/call-for-proposals-info.aspx

Other reminders were for a Birds of a Feather meeting and CDex STU2 during Jan conference, plus that the May WG meeting will be in New Orleans.

Mary Kay and Bob D joining to review the CDex X12 mapping table

Question on citation X12:

Bob stated that he has permission from X12 to uses X12 references in the mapping table.  Citation and IP are taken care of.  Mary Kay will take a look at the table and get back with the WG prior to the Jan WG meeting.  
Open floor
CDex and NPRM will roll over into the next meeting on 01/03/23.
 Adjourned at 3:33 PM EST

Supporting Documents

Outline Reference

Supporting Document

Minute Approval

Action items