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Department of Health and Human Services


Subcommittee on Standards and Security

July 30-31, 2007

Wilbur Cohen Building
330 Independence Avenue, S.W.
Washington, DC

Meeting Synopsis

The National Committee on Vital and Health Statistics Subcommittee on Standards and Security was convened on July 30-31, 2007. The meeting was open to the public and broadcast live on the Internet (


Committee Members

  • Jeffrey S. Blair, MBA, Co-Chairman
  • Harry Reynolds, Co-Chairman
  • Simon P. Cohn, MD
  • Judith Warren, PhD, RN


  • Justine M. Carr, MD
  • J. Marc Overhage, MD, PhD

Staff and Liaisons

  • Vivian Auld, NLM
  • Denise Buenning, MSM, CMS
  • Jorge Ferrer, MD, VA
  • Marjorie Greenberg, NCHS/CDC, Executive Secretary
  • Donna Pickett, NCHS/CDC
  • Steven J. Steindel, PhD, CDC
  • Karen Trudel, CMS


  • George Arges, AHA
  • Adam Birnbaum, BlueCross BlueShield
  • Michael J. DeCarlo, BlueCross BlueShield
  • Bill Finerfrock, Capitol Associates, Inc.
  • Maria A. Friedman, RXHUB
  • Gail S. Kocher, Highmark
  • Clarence G. Law, Dupont
  • Thomas M. Leary, HIMSS
  • Pam Matthews, HIMSS
  • Andrew Megson, CMS
  • Stanley Nachimson, Nachimson Advisors, LLC
  • Robert M. Tennant, MGMA
  • Richard B. Usry, HMS

*presenters listed below

Summary of Final Subcommittee Discussion

Dr. Steindel suggested that the Subcommittee recommend to the Secretary that they move forward with an NPRM for 5010. He indicated that the regulatory process must begin in order to coalesce industry opinion. Perceptions within the industry would change, he said, after an NPRM was published and its feedback analyzed by CMS. Dr. Blair spoke of a “window of opportunity” to educate the industry within the next six months to a year. Dr. Warren, who indicated that all Subcommittee members agreed with Dr. Steindel’s recommendation, wondered about the timeline. Dr. Cohn mentioned that CMS outreach was defined, for these purposes, as bringing together stakeholders and implementers to talk about strategy. He noted industry unanimity about a two-year implementation from publication of the final rule, which might be best accomplished at a different time than the ICD -10 implementation. Mr. Reynolds wanted to ensure that the 5010 business case would be well-known by the industry. As a matter of public record, Dr. Cohn stated that the Subcommittee welcomes letters and comments from the public. Mr. Blair recommended that the NPRM should: 1) alert the industry that a change is coming and encourage the industry to “start moving”; 2) strengthen the business case; and 3) clarify how testing should take place and determine who will coordinate and perform it.


  1. Dr. Warren, who will work with Mr. Reynolds and Ms. Buenning to draft the Subcommittee’s letter to the Secretary, requested input and definitions from Subcommittee members (e.g., “staggered implementation”; “pilot testing”; “plan”; “testing”; “certification”; “dual processing”; “NHIN”). The letter will include the Subcommittee’s recommendation that the NPRM go out. The intent is to present a letter for consideration by the full Committee at the September 2007 meeting.
  2. A conference call will be scheduled to review the draft letter.
  3. Dr. Cohn suggested a review of the Claims Attachment letter along with the recommended testing (i.e., prior to promulgation of the final rule).
  4. Dr. Cohn recommended consideration of how gathering information about testing, standards certification, and additional review could be reflected in the next HIPAA certification. He requested guidance or advice (possibly CMS might query the standards organizations as part of an NPRM).
  5. Dr. Cohn suggested that the Subcommittee assist CMS as it begins to develop an NPRM. The Subcommittee can provide a different view of return on investment and benefits. Ms. Trudel noted the importance of conveying the appropriate information to HHS policymakers.

Topics and Presenters

Monday, July 30, 2007

Welcome and Introductions Jeffrey S. Blair, Harry Reynolds
NPI Overview & Update Karen Trudel, CMS
Rationale for SDO Changes Margaret Weiker, EDS
NCPDP D.0 Margaret Weiker, EDS
Lynne Gilbertson, NCPDP
Overview of 5010 Issues/Benefits/Business Case Don Bechtel, HDX
Overview of WEDI Survey Results Lisa Miller, Payformance Health
Subcommittee Discussion Jeffrey S. Blair, Harry Reynolds

Tuesday, July 31, 2007

Welcome and Introductions Jeffrey S. Blair, Harry Reynolds
5010/D.0 Plans/Payor/PBM Panel Dwight C. Law, BlueShield of CA
Christine Stahlecker, CMS
Susan Mateja, State of Delaware Medicaid
Annette Gabel, MEDCO
5010/D.0 Vendor/Clearinghouse Panel Bing Herald, Past President, HBMA
Miriam Paramore, Integra Professional Services
Margaret Weiker, EDS
Linda Campbell, Smith Premier
5010 Provider/Pharmacist Panel Robert Ahlstrom, ADA
Karen Raines, HCA Healthcare; AHA
Larrie W. Dawkins, Wake Forest University
Physicians, MGMA
Michele M. Vilaret, NACDS
John Klinck, SuperValu, Inc.
Subcommittee Discussion Jeffrey S. Blair, Harry Reynolds

See official transcript for full Subcommittee discussion.