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  1. FHIR Specification Feedback
  2. FHIR-37546

Consent expiration for P2P Data Exchange

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US Da Vinci PDex (FHIR)
    • current
    • Financial Mgmt
    • PDex Implementation, Actors, Interactions, Data Payloads and Methods
      Payer-to-Payer Exchange [deprecated]
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      The following section "Period of Consent Validity" for the Payer-to-Payer Exchange page is proposed to clarify the options for applying an appropriate period of validity for the consent resource.

      Period of Consent Validity

      Here are some scenarios that could inform the decision about an appropriate period of validity for a consent to exchange health information:

      • Medicare has an annual enrollment. This can result in beneficiaries signing up for a new health plan up to 3 months before their new health plan goes into effect.
      • When a member's health plan is terminated it is not uncommon for claims and supporting information to be received by the health plan for a period of time after the plan terminates.
      • Some plan beneficiaries may have concurrent coverage. For example, a medicare and a medicaid plan may be in effect for a beneficiary for the duration of their plan. In this scenario health plans may need to exchange information about the beneficiary throughout the period of dual plan coverage in order to coordinate treatment.

      It is a member's option to share their health information with their new health plan. When a member chooses to grant consent for a health plan to retrieve their health data from a prior health plan the proposed period of consent MAY be:

      Scenario               Start Date               End Date                                    
      Scenario Consent Start Date Consent End Date
      Early Enrollment Date of enrollment 90 days after Plan Start Date
      Immediate Enrollment Date of enrollment 90 days after Plan Start Date
      Concurrent Plan Coverage Date of enrollment Plan Period End Date (typically 12 months from plan start date)
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      The following section "Period of Consent Validity" for the Payer-to-Payer Exchange page is proposed to clarify the options for applying an appropriate period of validity for the consent resource. Period of Consent Validity Here are some scenarios that could inform the decision about an appropriate period of validity for a consent to exchange health information: Medicare has an annual enrollment. This can result in beneficiaries signing up for a new health plan up to 3 months before their new health plan goes into effect. When a member's health plan is terminated it is not uncommon for claims and supporting information to be received by the health plan for a period of time after the plan terminates. Some plan beneficiaries may have concurrent coverage. For example, a medicare and a medicaid plan may be in effect for a beneficiary for the duration of their plan. In this scenario health plans may need to exchange information about the beneficiary throughout the period of dual plan coverage in order to coordinate treatment. It is a member's option to share their health information with their new health plan. When a member chooses to grant consent for a health plan to retrieve their health data from a prior health plan the proposed period of consent MAY be: Scenario               Start Date               End Date                                     Scenario Consent Start Date Consent End Date Early Enrollment Date of enrollment 90 days after Plan Start Date Immediate Enrollment Date of enrollment 90 days after Plan Start Date Concurrent Plan Coverage Date of enrollment Plan Period End Date (typically 12 months from plan start date)
    • Bob Dieterle / Mark Scrimshire : 9-0-0
    • Clarification
    • Compatible, substantive
    • Yes
    • 2.0.0-ballot

    Description

      It seems odd that the new payer has the ability to impose a validity time frame for Consent. Also, payers need to know how will the dates in the Consent capture screen look like. Can we reach an agreement regarding said time frame? Maybe 3 months from the request date? Any agreement would be better than no agreement at all.

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            Unassigned Unassigned
            ezekraken Ezequiel Morales
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              Updated:
              Resolved: