(1) In general.--The Secretary shall adopt standards for transactions, and data elements for such transactions, to enable health information to be exchanged electronically, that are appropriate for-- ``(A) the financial and administrative transactions described in paragraph (2); and ``(B) other financial and administrative transactions determined appropriate by the Secretary, consistent with the goals of improving the operation of the health care system and reducing administrative costs. ``(2) Transactions.--The transactions referred to in paragraph (1)(A) are transactions with respect to the following: ``(A) Health claims or equivalent encounter information. ``(B) Health claims attachments. ``(C) Enrollment and disenrollment in a health plan. ``(D) Eligibility for a health plan. ``(E) Health care payment and remittance advice. ``(F) Health plan premium payments. ``(G) First report of injury. ``(H) Health claim status. ``(I) Referral certification and authorization.

At least one of the following elements must be present: PractitionerRole.practitioner PractitionerRole.organization PractitionerRole.healthcareService PractitionerRole.location

Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.

The Network profile is based on USCore Organization Profile.

The Network profile is based on USCore Organization, since there was no contradiction between the USCore profile and the Plan-Net requirements.

CMS ASTP Response Provider Directory APIs with Issues

CMS/ASTP RFI Response: Provider Directory API that works

If we had truly robust standards for electronic data interchange and less anxiety about privacy, these kinds of data could be moved around more freely in a structured format. Of course, there are regional exchanges where they do. The data could also be created in structured format to begin with.