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  1. FHIR Specification Feedback
  2. FHIR-33216

Add guidance for use of Consent resource in Member-match operation

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US Da Vinci PDex (FHIR)
    • 1.0.0
    • Financial Mgmt
    • Payer-to-Payer Exchange [deprecated]
    • 4.2
    • Hide

      Add information about use of Consent resource in $member-match operation

       The Authorization with Consent workflow in the Health Record Exchange (HRex) IG adds a $MemberAccess operation which handles the consent.

      The Payer-to-Payer Exchange section in PDex has been updated to reflect the use of $memberAccess.

      The following text has been added:

       

      A Consent Resource SHOULD be provided as part of a $member-access transaction sent to the prior Payer. The resource is profiled in the Health Record Exchange (HRex) IG: http://hl7.org/fhir/us/davinci-hrex/. The consent resource identifies the categories of data to be exchanged with the member’s permission. There are two categories of data that can be exchanged:

      1. Everything: All data with no restrictions.
      2. Non-Additionally protected data classes.

      The CMS Interoperability Rule defines a set of data that can be excluded from data sharing. The restricted data classes are defined as:

      • Sensitive data classes identified in 42.CFR Part 2
      • Data identified as sensitive in state regulations, such as sexual and mental health data.

      These restricted data classes are excluded from the Non-Additionally protected data class.

      In situations where a data holder is unable to segregate data into the two data classes then no data should be released when a member has requested only Non-Additionally protected data be exchanged.

       

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      Add information about use of Consent resource in $member-match operation  The Authorization with Consent workflow in the Health Record Exchange (HRex) IG adds a $MemberAccess operation which handles the consent. The Payer-to-Payer Exchange section in PDex has been updated to reflect the use of $memberAccess. The following text has been added:   A Consent Resource SHOULD be provided as part of a $member-access transaction sent to the prior Payer. The resource is profiled in the Health Record Exchange (HRex) IG : http://hl7.org/fhir/us/davinci-hrex/ . The consent resource identifies the categories of data to be exchanged with the member’s permission. There are two categories of data that can be exchanged: Everything: All data with no restrictions. Non-Additionally protected data classes. The CMS Interoperability Rule defines a set of data that can be excluded from data sharing. The restricted data classes are defined as: Sensitive data classes identified in 42.CFR Part 2 Data identified as sensitive in state regulations, such as sexual and mental health data. These restricted data classes are excluded from the Non-Additionally protected data class. In situations where a data holder is unable to segregate data into the two data classes then no data should be released when a member has requested only Non-Additionally protected data be exchanged.  
    • Bob Dieterle / Chris Johnson: 12-0-1
    • Clarification
    • Compatible, substantive
    • Yes
    • 1.0.0

    Description

      HRex is adding Consent to the Member-Match transaction. Provide additional guidance in PDex for the use of Consent for Member authorization for payers to exchange data via payer-to-payer exchange.

       

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            Unassigned Unassigned
            ekivemark Mark Scrimshire
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            Dates

              Created:
              Updated:
              Resolved: