Chair: Mark Scrimshire
Scribe: Teresa Younkin
Create Decision from template
This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."
Minutes Approved as Presented
Agenda Topics
Agenda Outline | Agenda Item | Meeting Minutes from Discussion | Decision Link(if not child) |
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| Management | Review ANSI Anti-Trust Policy
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| Call Structure & Name Changes |
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Call for Da Vinci Member leads for PDex Use Cases If you are a Da Vinci member and interested in co-leading the PDex Use cases, please reach out to Vanessa Candelora and Viet Nguyen | |||
| Announcements | 1) Join us for the monthly public Community Roundtable
2) Da Vinci continues to monitor movement on a Prior Auth Rule: https://www.reginfo.gov/public/do/eAgendaViewRule?pubId=202110&RIN=0938-AU87 Title: ●Interoperability and Prior Authorization for MA Organizations, Medicaid and CHIP Managed Care and State Agencies, FFE QHP Issuers, MIPS Eligible Clinicians, Eligible Hospitals and CAHs (CMS-0057) Note: As early as February Timeline for NPRM that includes Medicare Advantage and Hospitals, Providers. 3) HL7 has now officially acquired Logica sandbox. They will now be able to address any issues and support for Jan. Connectathon. | 2.) They will be coming out with a NPRM for Interoperability and Prior Auth in February 2022. To include 90 day comment period including payers, Medicare Advantage, and provider organizations. 3.) Viet Nguyen is the primary point of contact for general questions. For any specific, technical issues, please submit a trouble ticket via the sandbox/Logica site. They will be collected and triaged. | |
| Preparing for HL7 January Connectathon | HL7 FHIR Connectathon (CST) January 10-12, 2022 • Virtual Event Register here: https://www.hl7.org/events/fhir/connectathon/2022/01/ Online registration closes December 13. Confluence Event page: 2022 - 01 Connectathon 29 Da Vinci summary- HL7 Virtual Connectathon - January 2022 Call for Testers! Particularly for PDex on:
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| PDex/HRex Payer to Payer - Security | Share updated status on Mutual TLS, UDap, and Consent discussions. Robert Dieterle
| Can support a UDAP stack with a trading partner and will meet requirements for Mutual TLS. Payer to Payer exchange: Moving consent resource back to member-match. If consent is revoked on either side there is no action taken (no query/no response). IG to be updated by first week in Jan 2022. | |
| PDex IG Updates | Mark Scrimshire Share updates to PDex IG to Section 4.0.3 including:
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| Implementer Support Questions | For member-match there is a requirement for the requester to have the consent, but the receiver does not have to store the consent resource b/c it s not referenced. Future discussions should be had regarding how payers handle the consent resource for those parties acting on behalf of the patient (caregiver/parent). | ||
| Chat: | |||
| Next Week | Today (12/17) 2pm ET call is cancelled. 12/24 to 1/3 - All open Da Vinci calls cancelled. Happy Holidays! The Connectathon Orientation will be recorded on the PDex 2pm call on 1/7. Starting week of 1/10: PDex, Formulary, and Plan Net will meet at 12noon on Fridays only. The 2pm call will be discontinued. | ||
| Adjournment | Adjourned at 12:45 pm | ||
Outline Reference | Supporting Document |
|---|---|
| Minute Approval | |
| PDex Companion Guides | |
| CARIN CPCDS to US Core Mapping | Latest draft CARIN CPCDS Mapping document: CARIN Mapping to FHIR interim 2020 0818 v2.xlsx DRAFT - PDEX US Core Mapping from CPCDS source: ResourceMappingUSCoreCPCDS-2020-05-29-v26.xlsx |
| PDex - US Core inter-relationship |
Source PowerPoint: PDEXandUSCoreRelationship.pptx |
| Da Vinci is seeking answers to open questions and clarifications needed on the implementation and operational needs of the upcoming CMS Patient Directed API Rules. | Find initial questions and corresponding answers shared from our colleagues at CMS here |
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| Other Links: | Source code is here: https://github.com/HL7/davinci-epdx
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Implementer Resources | Da Vinci Implementer Support Page Implementers can take advantage of tools: See the Reference links on the Payer Data Exchange (PDex) page to access links for Reference Implementations, sandboxes, test scripts, and more! Da Vinci PDex for Patient Access API Frequently Asked Questions (FAQs) CMS Final Rule Questions and Answers log ONC FAST National Healthcare Directory (including end points) solution page that includes links to everything (solution doc, Connectathon, HL7 workgroup, etc.): https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/National+Healthcare+Directory For questions, reach out to us on Zulip: |
| Formulary STU 1.1.0 Overview | |
| Recording of PDex Provenance Discussion 10/1/2021 | Recording of PDex Provenance Discussion 10/1/2021 |
| Recording of PDex calls on 10/29 | Discussion on Provenance Source and Transmitter - Payer Authoring; Authorized Rep rather than Patient request process for consent, and more. |
Action items
Attendees -
Ramandeep Dhanoa "Raman" Tom LoomisPresent Name Affiliation Present Name Affiliation Onyx Yukta Bellani Evernorth/Cigna Gevity MITRE Alex Kontur HealthLX MITRE Bryan Briegel IBM Watson Health Chris Johnson BCBSAL Evernorth Chetana Suresh IBC Stanley Nachimson Jim Denyer IBC Dave Shekar Mettle Solutions Ezequiel Morales Evernorth/Cigna Rachel E. Foerster Todd Grinaway CBC Versaggi Consultant James Derrickson BCBST Nehal Amin Tom Grannan Azuba Jason Teeple Vanessa Candelora POCP, Da Vinci PMO Kat Cobel NCQA Joel Hansen Mark Neumuth Aetna United Michael Ryan NCQA Joseph Quinn SmileCDR Rich Tallon Jamie Stamps Ronald Wampler CVS Aetna Health Muriel Brechner Evernorth Craig Knier Change Healthcare Jeff Brown MITRE, FM Co-Chair @Dustin R Nides Christopher Gracon Vernell Armstrong Bob Bowman Brett Atwood Dale Brown Evernorth Grace Stambaugh Optum Michelle Barry Availity Christopher Gracon Teresa Younkin POCP Stephan Roorda IBM Thomas Keane Michelle Benz Ujjawal Bhatnagar Douglas DeShazo LexisNexis