Universal API Implementation Guide
1.1.20 - ci-build

Universal API Implementation Guide - Local Development build (v1.1.20) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Release 2024 June 28

ANNOUNCEMENTS

  • When submitting a Patient Foundation enrollment, the serviceRequest.code.coding.code can now accept "gpf" or "patient foundation"



REMOVED

The following Access Solutions/GPF questionnaires have been removed:

Available in Test
Environment		 Product linkId Prescriber Form Version
valid until:		 Comments
Yes Venclexta "linkId": "venclexta-metastatic-disease" No change to current Venclexta PSF (v3) questionnaire removed as part of bundle cleanup
Yes Venclexta "linkId": "venclexta-disease-stage" No change to current Venclexta PSF (v3) questionnaire removed as part of bundle cleanup
Yes Evrysdi "linkId": "applied-for-copay" No change to current Evrysdi PSF (v7) removes ability to request for Copay SR for Evrysdi patients
Yes Evrysdi "linkId": "applied-for-appeals" No change to current Evrysdi PSF (v7) removes ability to request for Appeals SR for Evrysdi patients



ADDITIONS

The following Access Solutions/GPF questionnaires have been added:

SUSVIMO

Available in Test
Environment		 Product linkId Prescriber Form Version
valid until:		 Comments
Yes Susvimo "linkId": "susvimo-type-of-procedure" Ophthalmology PSF (v4)
valid until 12/13/24		 This is a multi select question. Both options can be selected.

A multi-select questionnaire is identified with "repeats" = true.



linkId: susvimo-type-of-procedure

{
  "linkId": "susvimo-type-of-procedure",
  "text": "Type of Procedure",
  "type": "choice",
  "enableWhen": [
    {
      "question": "applied-for-bipa",
      "operator": "=",
      "answerBoolean": true
    }
  ],
  "enableBehavior": "all",
  "required": true,
  "repeats": true,
  "answerOption": [
    {
      "valueString": "Initial Fill and Implant Procedure"
    },
    {
      "valueString": "Refill Exchange Procedure"
    }
  ]
}


Sample questionnaireResponse when selecting both options:

{
    "linkId": "susvimo-type-of-procedure",
    "text": "Type of Procedure",
    "answer": [
      {
        "valueString": "Initial Fill and Implant Procedure"
      },
      {
        "valueString": "Refill Exchange Procedure"
      }



VENCLEXTA

Available in Test
Environment		 Product linkId Prescriber Form Version
valid until:		 Comments
Yes Venclexta "linkId": "adot" No change to current Venclexta PSF (v3)  


linkId: adot

{
  "linkId":"adot",
  "text":"Anticipated Date of Treatment (Optional)",
  "type":"date",
  "enableWhen":[
    {
      "question":"applied-for-bipa",
      "operator":"=",
      "answerBoolean":true
    },
    {
      "question":"applied-for-appeals",
      "operator":"=",
      "answerBoolean":true
    }
  ],
  "enableBehavior":"any",
  "required":false,
  "repeats":false,
  "answerOption":[
    {
      "valueString":"YYYY-MM-DD"
    }
  ]
}



ENSPRYNG

Available in Test
Environment		 Product linkId Prescriber Form Version
valid until:		 Comments
Yes Enspryng "linkId": "preferred-sp-optional" No change to current Enspryng PSF (v4)  


linkId: preferred-sp-optional

{
  "linkId":"preferred-sp-optional",
  "text":"Preferred Specialty Pharmacy (Optional)",
  "type":"string",
  "enableWhen":[
    {
      "question":"applied-for-bipa",
      "operator":"=",
      "answerBoolean":true
    },
    {
      "question":"dispensing-through",
      "operator":"=",
      "answerString":"Specialty Pharmacy"
    }
  ],
  "enableBehavior":"all",
  "required":false,
  "repeats":false
}



EVRYSDI

Available in Test
Environment		 Product linkId Prescriber Form Version
valid until:		 Comments
Yes Evrysdi "linkId": "ship-to-2" No change to current Evrysdi PSF (v7) new 'ship to' linkId created specifically for Evrysdi Starter SR
Yes Evrysdi "linkId": "evrysdi-other-medicines-prescribed" No change to current Evrysdi PSF (v7)  


linkId: ship-to-2

{
  "linkId":"ship-to-2",
  "text":"C&R Ship To",
  "type":"choice",
  "enableWhen":[
    {
      "question":"applied-for-starter",
      "operator":"=",
      "answerBoolean":true
    }
  ],
  "enableBehavior":"all",
  "required":true,
  "repeats":false,
  "answerOption":[
    {
      "valueString":"Patient"
    },
    {
      "valueString":"Prescriber"
    },
    {
      "valueString":"Practice"
    }
  ]
}


linkId: evrysdi-other-medicines-prescribed

{
  "linkId": "enspryng-other-medicines-prescribed",
  "text": "Other Medicines Prescribed",
  "type": "string",
  "enableWhen": [
    {
      "question": "applied-for-pf",
      "operator": "=",
      "answerBoolean": true
    }
  ],
  "enableBehavior": "all",
  "required": true,
  "repeats": false
}


UPDATES

The following Access Solutions/GPF questionnaires have been updated:

VENCLEXTA

Available in Test
Environment		 Product linkId Description of Change Update Prescriber Form Version
valid until:		 Comments
Yes Venclexta "linkId": "pa-in-place" questionnaire now 'optional' "required": false No change to current Venclexta PSF (v3)  
Yes Venclexta "linkId": "authorization" questionnaire now 'optional' "required": false No change to current Venclexta PSF (v3)  
Yes Venclexta "linkId": "venclexta-other-medicines-prescribed" questionnaire now 'required' "required": true No change to current Venclexta PSF (v3)  
Yes Venclexta "linkId": "ship-to" answerOptions updated to remove 'Site of Treatment' Patient
Prescriber
Practice		 No change to current Venclexta PSF (v3)  
Yes Venclexta "linkId": "has-treatment-started" questionnare available on Starter Service Request (SR)

"enableWhen" updated to include Starter SR		 applied-for-pf= true

applied-for-copay=true

applied-for-starter=true		 No change to current Venclexta PSF (v3)  



ENSPRYNG

Available in Test
Environment		 Product linkId Description of Change Update Prescriber Form Version
valid until:		 Comments
Yes Enspryng "linkId": "pa-in-place" questionnaire now 'optional' "required": false No change to current Enspryng PSF (v4)  
Yes Enspryng "linkId": "authorization" questionnaire now 'optional' "required": false No change to current Enspryng PSF (v4)  
Yes Enspryng "linkId": "venclexta-other-medicines-prescribed" questionnaire now 'required' "required": true No change to current Enspryng PSF (v4)  
Yes Enspryng "linkId": "dispensing-through" answerOptions updated to include
'Buy and Bill'		 available answerOptions:

Specialty Pharmacy
Buy and Bill
N/A		 No change to current Enspryng PSF (v4)  


EVRYSDI

Available in Test
Environment		 Product linkId Description of Change Update Prescriber Form Version
valid until:		 Comments
Yes Evrysdi "linkId": "eligibility-reason" Update eligibility reason options for Evrysdi Patient Foundation.

Evrysdi Patient Foundation can only be requested when patient has No Insurance

remove answerOptions "Insured: No Coverage for Medication"
and "Insured: Can't afford Medication"		 answerOption value "No Insurance" is only available No change to current Evrysdi PSF (v7)  
Yes Evrysdi "linkId": "evrysdi-therapy-gap" questionnaire now 'required' "required": true No change to current Evrysdi PSF (v7)  
Yes Evrysdi "linkId": "ship-to" "enableWhen" condition updated to remove Starter SR option;
only available on patient foundation only

removed site of treatment as ship to option		 "enableWhen": "applied-for-pf" = true

answerOption:
Patient
Prescriber
Practice		 No change to current Evrysdi PSF (v7)  
Yes Evrysdi "linkId": "evrysdi-sma-type" questionnaire now 'optional' "required": false No change to current Evrysdi PSF (v7)F  
Yes Evrysdi "linkId": "evrysdi-smn2-copy-number" questionnaire now 'optional' "required": false No change to current Evrysdi PSF (v7)F