Is beneficiary coverage cost really minimally necessary?

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    • Type: Change Request
    • Resolution: Not Persuasive
    • Priority: Highest
    • US Da Vinci HRex (FHIR)
    • current
    • Clinical Interoperability Council
    • HRex Member Match Coverage Profile
    • 9.8.1 Resource Profile: HRexCoverage
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      This element is inherited from the base resource and is neither mandatory nor marked as must support.  So there's no expectation that implementers complying with HRex would do anything with this field.  We don't prohibit as there may be circumstances where the field is necessary/relevant in downstream use-cases.  Such use-cases would be covered under the general HRex rule of "must follow regulations" expectation, including 'minimum necessary'.

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      This element is inherited from the base resource and is neither mandatory nor marked as must support.  So there's no expectation that implementers complying with HRex would do anything with this field.  We don't prohibit as there may be circumstances where the field is necessary/relevant in downstream use-cases.  Such use-cases would be covered under the general HRex rule of "must follow regulations" expectation, including 'minimum necessary'.
    • Marti Velezis / James Tcheng : 6-0-1

      Is beneficiary coverage cost really minimally necessary? Minimum necessary requirements would apply, so I guess as far as the beneficiary cost info, it might depend on how the old payer defines minimum necessary for care coordination (or whatever health care operation they’re using to justify the exchange). Could lead to price fixing/anti trust concerns.

      Existing Wording:

      Coverage.costToBeneficiary.type

            Assignee:
            Unassigned
            Reporter:
            Celine Lefebvre
            Celine Lefebvre
            Watchers:
            2 Start watching this issue

              Created:
              Updated:
              Resolved: