Details
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Change Request
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Resolution: Persuasive with Modification
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Medium
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US Da Vinci PDex (FHIR)
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STU3
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Financial Mgmt
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(profiles) [deprecated]
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2-2-2
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Bob Dieterle / Mark Scrimshire : 15-0-0
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Enhancement
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Compatible, substantive
Description
Existing Wording: 2-2-2 Member-mediated Information Exchange
The CMS Notice For Proposed Rule Making for Patient access and Interoperability requires that a subscriber to a new health plan SHALL be able to request their information to be passed from their old health plan to their new health plan.
A Member SHALL also be able to use APIs to share information with Third Party Applications. This includes:
•Their health history
•Healthcare network/directory information
•Pharmacy network/directory information
•Prescription Drug Formulary information
Proposed Wording: 2-2-2 Member-mediated Information Exchange
The CMS Notice For Proposed Rule Making for Patient access and Interoperability requires that a subscriber to a new health plan SHALL be able to request their information to be passed from their old health plan to their new health plan.
The Health Plan SHALL create a Provenance Provenance Record documenting the source of the Member records, the identity of the health plan and the action taken to become the custodian of the data. The updated Provenance record SHALL be passed on to any downstream entity requesting the associated records.
A Member SHALL also be able to use APIs to share information with Third Party Applications. This includes:
•Their health history
•Healthcare network/directory information
•Pharmacy network/directory information
•Prescription Drug Formulary information
ADD@http://hl7.org/implement/standards/fhir/us/davinci-pdex/2019Jun/6-7_Handling_Data_Provenance.html
6-7-1-2 Member information shared without Provenance
The Health Plan SHALL create a Provenance Provenance Record documenting the source of the Member records, the identity of the health plan and the action taken to become the custodian of the data. The updated Provenance record SHALL be passed on to any downstream entity requesting the associated records.
Comment:
Payers must create Provenance records for Member records received through Member-mediated Information Exchange.
Summary:
Payers must create Provenance records for Member records received through Member-mediated Information Exchange.
Attachments
Issue Links
- is voted on by
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BALLOT-9975 Negative - Kenneth Rubin : 2019-Sep-FHIR IG PDex R1
- Balloted