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Packagejohnmoehrke.xacml-consent.example
Resource TypeImplementationGuide
IdImplementationGuide-johnmoehrke.xacml-consent.example.json
FHIR VersionR4
Sourcehttps://build.fhir.org/ig/JohnMoehrke/xacml-consent/index.html
URLhttp://johnmoehrke.github.io/xacml-consent/ImplementationGuide/johnmoehrke.xacml-consent.example
Version0.1.0
Statusdraft
Date2026-02-11T17:02:27+00:00
NameJohnMoehrkeXACMLConsentExample
TitleJohn Moehrke XACML Consent Example
Realmuv

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Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: ImplementationGuide johnmoehrke.xacml-consent.example

JohnMoehrkeXACMLConsentExample

The official URL for this implementation guide is:

http://johnmoehrke.github.io/xacml-consent/ImplementationGuide/johnmoehrke.xacml-consent.example

Source1

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          "reference": "Consent/Consent-AB352-Example4"
        },
        "name": "AB352 Organizational Privacy Consent - four deep",
        "description": "A FHIR Consent instance that is an explicit consent for AB 352 protected data, with provisions that reflect the statutory requirements, with auto-filter bypassed for in-state recipients, and exception for data from 2014.\n\n- permit TPO for All data\n  - deny AB352sensitive data [for TPO] (essentially for out-of-state)\n    - permit in-state AB352 sensitive data [for TPO] (in-state, auto-filter bypassed)\n      - deny in-state AB352 sensitive data from 2014",
        "exampleBoolean": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "ValueSet"
          }
        ],
        "reference": {
          "reference": "ValueSet/vs-ab352-segmentation-tags"
        },
        "name": "AB352 Segmentation Tags",
        "description": "ValueSet of security labels used to segment AB352-sensitive health information in meta.security.",
        "exampleBoolean": false
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "ValueSet"
          }
        ],
        "reference": {
          "reference": "ValueSet/vs-abortion-topics-healthnet"
        },
        "name": "Abortion-Related Health Topics (Health Net California)",
        "description": "Health Net explains and references 500073-Abortion-DX-Code-List.pdf file primarily within its Provider Library and through Provider Bulletins related to legislative compliance. The specific explanation is found in the context of Assembly Bill (AB) 352, which mandates the segregation and protection of sensitive health data.\n\n**Where the Explanation is Located:**\n\n1. **Provider Bulletin 24-351 (New Laws Help Safeguard Privacy):** Health Net (and its affiliate Wellcare) issued this bulletin to explain the requirements of AB 352. The bulletin explicitly identifies abortion and abortion-related services as \"Sensitive Services\" that must be:\n   - Segregated from the rest of the patient's medical record.\n   - Excluded from automatic sharing with the California Data Exchange Framework (DxF).\n   - Protected from out-of-state subpoenas or investigations.\n   - **Reference:** [Wellcare/Health Net Bulletin 24-351](https://providerlibrary.healthnetcalifornia.com/)\n\n2. **Health Net Provider Library - `Pregnancy Termination` Section:** The website hosts a dedicated page for pregnancy termination benefits. It explains that to comply with California laws (specifically SB 245 for cost-sharing and AB 352 for privacy), providers must use specific diagnosis codes. The 500073 PDF serves as the technical master list for these required codes.\n   - **Reference:** [Pregnancy Termination - Health Net Provider Library](https://providerlibrary.healthnetcalifornia.com/)\n\n3. **The PDF Itself:** The document title, `ICD-10-CM Codes for Abortion-Related Services,` is the direct label Health Net uses on its search results and directory pages to explain what the file contains. It lists codes ranging from O00 (Ectopic pregnancy) to Z33.2 (Encounter for elective termination).\n\n**How Health Net Directs Providers to Use This File:**\n\nAccording to the site's AB 352 guidance, Health Net recommends that IT and Billing departments download this PDF and use the listed codes to create firewalls in EHR systems. If a patient's record contains any code found in 500073-Abortion-DX-Code-List.pdf, the system should automatically:\n- Block that data from being sent to out-of-state entities.\n- Prevent the data from being discovered in automated health information exchanges.\n\n**Direct Link to the Document:** [500073-Abortion-DX-Code-List.pdf](https://providerlibrary.healthnetcalifornia.com/content/dam/centene/healthnet/pdfs/providerlibrary/500073-Abortion-DX-Code-List.pdf)\n\n**Note:** This list may not be all-inclusive and is subject to change.",
        "exampleBoolean": false
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "Location"
          }
        ],
        "reference": {
          "reference": "Location/ca-location"
        },
        "name": "California Location",
        "description": "Location resource representing California for use in Consent provisions.",
        "exampleBoolean": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "ValueSet"
          }
        ],
        "reference": {
          "reference": "ValueSet/vs-contraception-ai"
        },
        "name": "Contraception-Related Health Topics",
        "description": "Clinical concepts related to contraception drawn from LOINC, SNOMED CT, and ICD-10-CM.\nIntended for segmentation of sensitive reproductive health information under AB352.\n\nThis ValueSet does not include code recommendations from Health Net California. Health Net California does not have a single source document for contraception-related codes similar to their abortion-related code list. Instead, Health Net references multiple sources, including the DHCS Family PACT Code List, within various policy documents.\n\n- **Health Net Bulletin 24-351:** New Laws Help Safeguard Privacy ([View Link](https://providerlibrary.healthnetcalifornia.com/))\n- **Health Net Medi-Cal Provider Manual (Chapter 4):** Sensitive Services section ([Link to Manuals](https://providerlibrary.healthnetcalifornia.com/))\n- **Family PACT Policies:** Health Net adopts the DHCS Family PACT Code List as their baseline for identifying what constitutes a contraceptive service.",
        "exampleBoolean": false
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "DocumentReference"
          }
        ],
        "reference": {
          "reference": "DocumentReference/xacml-patient-consent-12345"
        },
        "name": "DocumentReference of the XACML Consent policy",
        "description": "Example of a xml XACML Consent policy for Patient 12345 in a DocumentReference.",
        "exampleBoolean": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "DocumentReference"
          }
        ],
        "reference": {
          "reference": "DocumentReference/xacml-overriding"
        },
        "name": "DocumentReference of the XACML overriding policy",
        "description": "Example of a xml XACML overriding policy DocumentReference.",
        "exampleBoolean": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "Patient"
          }
        ],
        "reference": {
          "reference": "Patient/ex-patient"
        },
        "name": "Dummy Patient example",
        "description": "Dummy patient example for completeness sake. No actual use of this resource other than an example target",
        "exampleBoolean": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "Consent"
          }
        ],
        "reference": {
          "reference": "Consent/ExampleFHIRConsentXACMLcopy"
        },
        "name": "Example FHIR Consent with copy of XACML Policies",
        "description": "An example instance of a FHIR Consent resource that references XACML policies for access, and a copy of the patient specific XACML policy is included as a DocumentReference.",
        "exampleCanonical": "http://johnmoehrke.github.io/xacml-consent/StructureDefinition/fhir-consent-xacml"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "Consent"
          }
        ],
        "reference": {
          "reference": "Consent/ExampleFHIRConsentXACMLreference"
        },
        "name": "Example FHIR Consent with references to XACML Policies",
        "description": "An example instance of a FHIR Consent resource that references XACML policies for access, and does not include any rules directly in the Consent.",
        "exampleCanonical": "http://johnmoehrke.github.io/xacml-consent/StructureDefinition/fhir-consent-xacml"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "StructureDefinition:resource"
          }
        ],
        "reference": {
          "reference": "StructureDefinition/fhir-consent-xacml"
        },
        "name": "FHIR Consent with XACML Policies",
        "description": "A FHIR Consent resource that references XACML policies for access control, without including any rules directly in the Consent. Therefore, it does not include any provisions directly within the Consent. The actual access rules are defined in the referenced XACML policy documents.",
        "exampleBoolean": false
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "ValueSet"
          }
        ],
        "reference": {
          "reference": "ValueSet/vs-gender-affirming-care-healthnet"
        },
        "name": "Gender-Affirming Care Codes (Health Net California)",
        "description": "CPT and ICD-10-CM codes referenced in Health Net California's clinical policy\n'HNCA.CP.MP.496 - Gender Affirming Procedures'. Intended for segmentation of\ngender-affirming care under AB352.\n\n**Health Net Bulletin 24-351**\n\nHealth Net's [bulletin 24-351](https://providerlibrary.healthnetcalifornia.com/) explicitly tells providers that services defined in policies like HNCA.CP.MP.496 must be:\n\n- **Blocked from automatic sharing** with the California Data Exchange Framework (DxF).\n- **Omitted from responses** to out-of-state subpoenas or investigations.\n- **Flagged within the EHR** to prevent unauthorized access by users outside of California.\n\n**Where to Find and Download HNCA.CP.MP.496.pdf** Health Net maintains this policy in several locations within their provider libraries:\n\n- **Direct PDF Link:** [HNCA.CP.MP.496 - Gender Affirming Procedures](https://providerlibrary.healthnetcalifornia.com/content/dam/centene/healthnet/pdfs/providerlibrary/HNCA.CP.MP.496.pdf)\n- **The Provider Library Archive:** You can find this by navigating to Health Net Provider Library > Resources > Clinical Policies and searching for `Gender Affirming Procedures` or the code `496.`",
        "exampleBoolean": false
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "CodeSystem"
          }
        ],
        "reference": {
          "reference": "CodeSystem/cs-health-sensitivity"
        },
        "name": "Health Information Sensitivity Categories",
        "description": "Code system defining sensitivity categories for health information segmentation under California AB352.\n\nNote did not use HL7 v2-ActCodes as two of the three categories are not represented there, and the GENDER code may be more broad than GENDER_AFFIRMING_CARE as intended here.",
        "exampleBoolean": false
      }
    ],
    "page": {
      "extension": [
        {
          "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl": "toc.html"
        }
      ],
      "nameUrl": "toc.html",
      "title": "Table of Contents",
      "generation": "html",
      "page": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "index.html"
            }
          ],
          "nameUrl": "index.html",
          "title": "Home",
          "generation": "markdown"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "ab352.html"
            }
          ],
          "nameUrl": "ab352.html",
          "title": "Ab 352",
          "generation": "markdown"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "generic.html"
            }
          ],
          "nameUrl": "generic.html",
          "title": "Generic",
          "generation": "markdown"
        }
      ]
    },
    "parameter": [
      {
        "code": "path-resource",
        "value": "fsh-generated/resources"
      },
      {
        "code": "path-resource",
        "value": "input/examples"
      },
      {
        "code": "path-resource",
        "value": "input/capabilities"
      },
      {
        "code": "path-resource",
        "value": "input/extensions"
      },
      {
        "code": "path-resource",
        "value": "input/models"
      },
      {
        "code": "path-resource",
        "value": "input/operations"
      },
      {
        "code": "path-resource",
        "value": "input/profiles"
      },
      {
        "code": "path-resource",
        "value": "input/resources"
      },
      {
        "code": "path-resource",
        "value": "input/vocabulary"
      },
      {
        "code": "path-resource",
        "value": "input/testing"
      },
      {
        "code": "path-resource",
        "value": "input/history"
      },
      {
        "code": "path-pages",
        "value": "template/config"
      },
      {
        "code": "path-pages",
        "value": "input/images"
      },
      {
        "code": "path-tx-cache",
        "value": "input-cache/txcache"
      }
    ]
  }
}