Facilitator:  Peter Gunter 

Scribe: Robin Isgett  

Attendees

Present

Name

Affiliation

xco-chair HCSC
xChristol Green co-chair ELH
xChris Johnson interim co-chair BCBSAL
x
     x
     x
     x
     x
     x
x
x
x
     x@Robert Dieterle

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

Management

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.

Read Anti-Trust statement.
Management

 Minutes Approval  - Jan WGM NV notes,   Jan 24, 2023 Weekly WG meeting

Approved meeting minutes by consent.  Mike motioned to approve Jan WG minutes and Alix seconded.  Minutes approved by consent.
Management

New Proposals and PSS for review - PIE comments or interest

No new project proposals or scope statements.
Management

Updated Charter to include Artifacts.  We move the section from Mission to Charter per TSC request.

Charter

PIE WG will produce normative and informative standards for administrative and clinical records/data sharing between healthcare entities to support payer/provider processes.   We will work closely with appropriate Work Groups to coordinate HL7 artifacts. PIE will actively review administrative information interchange standards other than HL7 in an attempt to improve the development of interoperable standards and operating rules.

Artifacts may include concepts such as, Implementation Guides, Health Stories, and Use Cases to support:

  • healthcare claims or encounters
  • healthcare services review (e.g., prior authorizations/precertification’s, referrals)
  • claim audits
  • coverage requirements discovery
  • value based care (e.g., analytics, care management, reporting, care gaps etc.)
  • providing patient access to healthcare data 

Rachel made a motion to change wording in second paragraph that starts with "Artifacts may include...." from coverage requirements discovery to benefits and coverage.  Greg seconded the motion.

VOTE:  13-0-0


All

CMS Proposal to Adopt Standards for Health Care Attachments Transactions and Electronic Signatures; Modify Referral Certification and Authorization Transaction Standard

Discussion Guide with some comments loaded to our Documentation/Presentations area for review and others comments

This NPRM is based on work and comments from x12, HL7 and others that NCVHS received in 2016 and transmitted to Secretary of HHS July 5 2016.  The testimony that NCVHS used to inform the rule is 7 years old.  The industry has moved toward end-to-end real-time capabilities for our health care communities.

We should go back and look at original HIPAA regulations, SSA, and ACA to be able to properly parse the next sentence.

We support a national electronic healthcare claims and PA attachment standard, but there are more flexible technologies that provide for more efficient exchange of clinical information.  Complexity is reduced in

We do not want to be bound by a technology that is no longer relevant.

We need a framework that allows FHIR.

If this rule is withdrawn it will alleviate burden and cost on providers and EMR/vendors to update their platforms first for HIPAA  X12 275 (old technology) and then for FHIR updates for real-time interactive solutions like HL7 CDex



All 

Advancing Interoperability and Improving Prior Authorization NPRM 

Discussion Guide review

Reviewed current comments.  Christol asked all on the call to review the document and add to it for our next meeting.  Regarding compliance deadlines, Bob stated that , per HIPAA, any new standards must be implemented within 24 months from date of final rule.  Dates are subject to change.  Could also ask that final rule be delayed.
Open Floor

Alix asked if meeting could start at 2:00 and spend entire discussion on NPRM comments.


Management Next agendaContinue NPRM discussion.
 Adjournment
 Adjourned at 3:29 PM EST

Supporting Documents

Outline Reference

Supporting Document

Minute Approval


Action items

  •