On April 10, the Centers for Medicare and Medicaid Services (CMS) published the Interoperability and Prior Authorization for Drugs Proposed Rule, to streamline the exchange of clinical and administrative data. Specifically, a series of ONC proposals are included as a rider in the CMS proposed rule and would adopt a suite of new standards related to electronic prior authorization, payer-to-payer data exchange, and other burden reduction specifications developed by the HL7 FHIR® Da Vinci Project. ONC proposes to adopt the newest versions of several HL7 FHIR® implementation specifications, including: - HL7 FHIR® Da Vinci—Coverage Requirements Discovery (CRD) Implementation Guide, Version 2.2.1—STU 2.2
- HL7 FHIR® Da Vinci—Documentation Templates and Rules (DTR) Implementation Guide, Version 2.2.0—STU 2.2
- HL7 FHIR® Da Vinci—Prior Authorization Support (PAS) FHIR Implementation Guide, Version 2.2.1—STU 2.2
- HL7 FHIR® CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®) Implementation Guide, Version 2.2.0—STU 2.1
- HL7 FHIR® Da Vinci Payer Data Exchange (PDex) US Drug Formulary Implementation Guide, Version 2.1.0—STU 2.1
- HL7 FHIR® Da Vinci Payer Data Exchange (PDex) Plan Net Implementation Guide, Version 1.2.0—STU 1.2
- HL7 FHIR® Da Vinci—Clinical Data Exchange (CDex) Implementation Guide, Version 2.1.0—STU 2.1
In parallel with these proposals, ONC and CMS have announced a collaborative testing roadmap for these versions of Da Vinci specifications, leveraging the Inferno Test Tool. Test kits for CRD version 2.2.1 are under development now, and we intend to make these test kits available for both payer-side and provider/EHR-side testing by early summer. |