Stream: Da Vinci PDex
Topic: Patient Access P2P Consent
Mark Neumuth (Dec 07 2021 at 21:48):
We are currently planning for CMS 9123 rule and have some questions regarding members opting-in to Payer-to-Payer during enrollment. From the prior ruling that was pulled back: impacted payers must create a process to allow members to opt-in to permit the payer to use the Payer-to-Payer API for bulk access with other payers at enrollment and quarterly with concurrent payers as described below.
1) If a member does not provide consent at enrollment how are payers handling this? Are procedures being put in place for post-enrollment capture?
2) Are any payers leveraging pre-enrollment systems to handle consent? It seems this ruling would change some of our enrollment forms if we end up touching the pre-enrollment process which would be a large effort.
3) Once a member grants consent at enrollment how long is it valid? Will other payers proactively ask members if they have concurrent plans? How often?
4) If a member revokes consent are payers removing the "other payer" data or just stopping the transition of data going forward?
Lloyd McKenzie (Dec 07 2021 at 23:23):
@Mark Scrimshire
Mark Neumuth (Dec 08 2021 at 22:34):
@Lloyd McKenzie You mentioned managing consent expectations is being discussed in the Friday PDex calls. Is that the noon EST call or the one later in the afternoon (3:00 EST?).
Lloyd McKenzie (Dec 09 2021 at 03:32):
Typically the second one
Mark Scrimshire (Dec 21 2021 at 09:45):
We are reverting to a single PDex Call in the New Year. The PDex call will take place at Noon ET on Fridays.
Last updated: Apr 12 2022 at 19:14 UTC
