2023-01-04 CDex/HRex Meeting

The January 18th CDex call will be cancelled 

CMS Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule (CMS-0057-P)

• Federal Register (officially published 12/13/22)
• Fact Sheet
• Comment period closes 3/13/2023

Administrative Simplification: Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction Standard Proposed Rule (CMS-0053-P)

• Federal Register (published on 12/21/22)
• Comments due 3/21/23

January Ballot Cycle 

• Da Vinci Member Attribution List Implementation Guide is included
• Commenting and voting takes place through January 9, 2023

• Working with the RI Team to incorporate updates before the Connectathon., Hoping to simulate some of the new functionality with regard to questionnaire. 
• Details related to using questionnaire are included in the track page. 
• Watch the track page for updates. 
• PreConnectathon survey went out to registrants yesterday: https://www.surveymonkey.com/r/9ZPYSND 

FHIR-38585 - Getting issue details... STATUS

• Bob sent some proposed language to help finalize this ticket
• RF: Proposed language tries to bring into view all of the various Da Vinci IGs that would have a part in this.
• BD: Yes, it notes that because this is a general tool, it will have overlaps with other specific IGs. The goal is to determine when and where this IG is appropriate. It's appropriate in 3 cases (as described). The IG asks for data from a provider, not necessarily in real time. Doesn't provide full review/approval before release so reasonable to use CDex which allows you to specify review process. In PAS, we have a need to ask for additional information and CDex fills this need. 
• AP: The SHALL use CDex will be added to PAS? 
• BD: Yes
• AP: How will that work with the attachments rule should it go forward as is?
• BD: If it goes forward as is, neither will work. Putting it here can't make things any worse. 
• EH: Any comments on Attachment rule? 
• BD: Will be sharing updates with Da Vinci member first, then will bring back to this group. 
• RF: It's starting to appear that the way this is going, it would enable the industry to use PAS with CDex and go with total FHIR exchanges rather than having to map to X12. 
• BD: There is nothing here that replaces the need to map to the 278. 
• RF: Agree. But this is a tool/technique that would avoid having to do that if regulations permitted.
• BD: This is really about attachments. Doesn't replace the PA process. It replaces the clinical attachment process. 
• RF: Noticed you used the word "clinical data" but to support PA, there are needs to support information that is "clinical" - over a 1,000 LOINC codes in the HIPAA tab. 
• BD: Anything in the proposed language that folks wish to change?
• CG: Last paragraph might need enhanced. used for other things other than request for a provider? It could be used for provider sending information to payer (e.g., the unsolicited scenario). 
• BD: Right - this was supposed to cover CDex as a whole. 
• CG: The "only" is a problem - remove that piece
• RF: Could we change to "CDex may be used.." ? 
• CG: Maybe just say "for additional clarity, CDex is intended to be used when there is a need for information form a provider and there is no coverage of the use case by a separate published IG." Or maybe "CDex is intended to be used when supplemental information is needed from a provider" 
• BD: You are only thinking of attachments portion. If I'm another provider, it's not considered supplemental information. 
• CG: What if we just say "additional information from a provider"
• BD: Maybe just remove the first sentence. 
• YH: For DEQM, can we take out the first bullet about measure not yet implementable using DEQM. The measure itself not represented it can still be used by DEQM for quality reporting. 
• BD: What if it's a payer specific measure not covered by DEQM
• YH: They can still report that measure using DEQM, unless there is some unique measure type not yet supported by DEQM?
• BD: Think that's the intent. How about saying "the specific measure type is not yet supported by DEQM."
• YH: Mixing how you represent the measure and how you report. 
• BD: If we just put "type" after "measure" does that address the concern? 
• YH: DEQM is specific to reporting, it doesn't represent the measure; it's pretty comprehensive because you can report just about anything. The language isn't intended to be comprehensive, so just take out the first bullet. 
• BD: Will remove example #1 from that section. 
• SN: Is there a spot where we could suggest business use cases for each implementation guide (e.g., a white paper)? 
• BD: It actually does this in the table that is linked in the first paragraph. CDEX Overlap with Other DaVinci IGs 
• SN: I think this is going in the right direction.
• BD: It's challenging because we exchange clinical data for a wide range of use cases. 
• Ticket will be marked ready for vote when JIRA is back up and running. 

13:05:49 From Crystal Kallem (POCP / Da Vinci PMO) To Everyone:
    Today's agenda: https://confluence.hl7.org/pages/viewpage.action?pageId=144991370
13:17:36 From Yan Heras To Everyone:
    https://www.surveymonkey.com/r/9ZPYSND
13:21:40 From Eric Haas To Everyone:
    http://build.fhir.org/ig/HL7/davinci-ecdx/
13:27:27 From Crystal Kallem (POCP / Da Vinci PMO) To Everyone:
    https://jira.hl7.org/browse/FHIR-38585
13:57:16 From Crystal Kallem (POCP / Da Vinci PMO) To Everyone:
    https://confluence.hl7.org/display/DVP/CDEX+Overlap+with+Other+DaVinci+IGs

Adjourned at 3:01 PM ET