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CARIN Blue Button (PSS in Confluence)

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Basics

CARIN Blue Button (PSS in Confluence)

1538
Ballot - STU to Normative


FHIR Implementation Guide

Implementation Guide

Details

Develop a FHIR R4 based implementation guide for an API similar to the CMS Medicare Blue Button 2.0 API, FHIR R3 based, that will allow consumer-directed exchange of commercial Health Plan/Payer adjudicated claims data to meet the requirements of the CMS Interoperability and Patient Access proposed rule.


MA, CHIP, Medicaid Managed Care and QHP Plans will have to adopt a standards-based API in the CMS Interoperability and Patient Access proposed rule so beneficiaries can connect an app of their choice to their claims. The rule has a current proposed implementation date of 1/1/2020. Health plans are required to use standards-based API options, including CMS Medicare Blue Button 2.0 and this implementation guide will provide a FHIR R4 means to meet those requirements. This implementation guide will help those plans meet the proposed regulatory requirements.



A FHIR R4 Implementation Guide


https://confluence.hl7.org/display/FM/PSS+for+CARIN+Blue+Button https://trifolia-fhir.lantanagroup.com/implementation-guide/carin-bb2/view

CARIN Alliance


Regulatory Agency, Payors, Other (specify in Misc. Notes below),Healthcare Institutions (hospitals, long term care, home care, mental health),EHR, PHR; Health Care IT; Other (specify in Misc. Notes below)

Cambia Health, BCBSA, United Health Care, Kaiser Permanente, BCBS of NC, Humana, Security Health Plan

March 2019 Interoperability and Patient Access Proposed Rule by CMS

BlueButton


Yes

N/A

No

2025 January: TSC approved Unballoted STU Update Publication Request for HL7 FHIR Implementation Guide: Consumer-Directed Payer Data Exchange, Release 2.1 - US Realm 2024 December: TSC approved STU Extension Request for CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button) STU2.0 for 2 years 2022 Sept: TSC Approved STU Publication Request for CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button) v2.0.0 2021 June: TSC approved Unballoted STU Update Publication Request for CARIN IG for Blue Button Other Stakeholders: Analytics firms Other Vendors: Personal Health Record Apps
Organization & Realm

Realm Specific - Enter "U.S." or name of HL7 Affiliate below

U.S.
People

Amol Vyas, Ryan Howells



Financial Management Work Group


Status & Dates

Active

STU - Test Period/Accepting Comments

05/22/2019

01/01/2027

2027 Jan WGM/Ballot

01/01/2027

2027 Jan WGM/Ballot

2022 Jan Ballot Cycle Info: STU Ballot results: Met basic vote requirements. 25 Negatives to reconcile Document Name: HL7 FHIR Implementation Guide: Consumer-Directed Payer Data Exchange, Release 2 - US Realm (See Jira Ballot Dashboard) 2020 Feb Ballot Cycle Info: STU Ballot results: Met basic vote requirements. 27 Negatives to reconcile Document Name: HL7 FHIR Implementation Guide: Consumer-Directed Payer Data Exchange, Release 1- US Realm
Approvals

10/14/2019


Received


All Received




System Info



View Ballot Items (with NIBs)




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