Roll Call: Brandi Wyatt Marcallee Jackson Rama Pidapartee Sue Ryder Jerry Cappendorf John Oleksyn Tim Collins Kerry Zajicek Brian Ross Kepa Zubeldia John Lilleston
New Testing SWG Co-Chair Sue will be participating as a SNIP Co-Chair and we are requesting nominations for the open Testing co-chair position. Candidates must have been active Testing SWG participant. Nominations should be sent to John and/or Sue by close of business Friday 06/20/03. Our recommendation will then be presented to the Transactions co-chair and then to the Steering Committee for approval. Issues Database Can a health plan mandate a third party certification. If so can they also mandate a specific third party. And finally can the health plan require the provider to pay for the certification. Marcallee summarized the issue and the responses received to date. After our discussion we agreed that the issue had to be further clarified as to whether the certification pertained to IG compliance testing or business/companion guide testing. The group agreed that business or companion guide testing can be required by a health plan, the health plan can require a specific third party certification, but the health plan should pay for the certification cost. The group agreed that IG compliance testing can be required by a health plan. However we were unable to come to a consensus on whether the health plan could specify the third party and whether they could require the provider to pay the costs. We questioned whether accepting compliance from any third party certification presumes all third party certification can perform the same health plan testing requirements. It was suggested that if the health plan required a specific third party certification that they provide details on the criteria used on selecting/excluding third party certification. Emails had referenced the final rule's requirement that a covered entity may not delay or adversely impact the use of the HIPAA transactions. It was asked if CMS should be consulted from an enforcement aspect on the issue. Marcallee note that the issue had been brought to their attention. It was suggested that CMS be invited to participate in our next meeting and Marcallee volunteered to contact them. Marcallee also agreed to try and summarize all of the emails received on the issue and distribute to the SWG. Tim noted that as a Medicaid payer they were not requiring third party certification and each provider regardless of having certification would be required to pass their testing. It was recommended that we try and get more input from payers and providers. The issue would be mentioned at the RSA meeting this afternoon. Sue would also send the issue to Rich Landen to see if he could solicit input from the Blue plans. Status of Testing Survey John and Sue had requested Transaction co-chair approval and would finalize with the co-chairs at Monday's meeting. This would allow the survey to be presented at Friday's (06/27/03) Steering Committee meeting. Next Steps for SWG Brandi has recommended an end- to-end testing white paper and volunteered to facilitate a work group to develop an outline for the Transaction co-chairs. Volunteers should email Brandi at [EMAIL PROTECTED] The group especially needs provider and payer participation. Marcallee noted that NJShore had a banking testing white paper that might be a good reference. Next meeting will be July 17th. "WellChoice, Inc." made the following annotations on 06/19/2003 03:04:01 PM ------------------------------------------------------------------------------ Attention! This electronic message contains information that may be legally confidential and/or privileged. The information is intended solely for the individual or entity named above and access by anyone else is unauthorized. 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