US HR1 Medicaid Work Requirements IG (proposed, not supported by CMS)
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Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

Work Requirements Condition

Condition resource for pregnancy, medically frail, child disability, etc.

Work Requirements Coverage

Represents TANF/SNAP program coverage eligibility

Work Requirements Encounter

Represents inpatient care or medical hardship encounters

Work Requirements EpisodeOfCare

Represents participation in treatment programs

Work Requirements Observation

Observation for program compliance, incarceration, foster status, functional status

Work Requirements Patient

Patient profile for Medicaid Work Requirements

Work Requirements Related Person

Represents parent/caretaker relationship to dependent child

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

US Core Tribal Affiliation Extension

Indicates tribal affiliation for American Indian/Alaska Native patients

Terminology: Naming Systems

These define identifier and/or code system identities used by systems conforming to this implementation guide.

VeteranId

Identifier assigned to veterans by the U.S. Department of Veterans Affairs.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Child Disability (example)

Optional child disability condition

Declared Disaster

Observation representing disaster impact

Dependent Child (under 13)

Child patient for parent/caretaker example

Example Medicaid Patient (under 19)

Patient under 19 years old

Foster Care Status

Observation representing foster care status

Functional Status (example)

Example observation supporting medically frail status

Hospital (Service Provider)

Hospital organization for inpatient encounter

Incarceration Status

Observation representing incarceration period/status

Inpatient Encounter

Encounter representing inpatient care (IMP)

Managing Organization (Treatment Program)

Organization managing the treatment episode

Medically Frail Example Condition

Example condition indicating medically frail status

Parent of Dependent Child

RelatedPerson linking parent to child with v3-RoleCode PRN

Pregnancy (SNOMED 77386006)

Pregnancy condition per SNOMED CT

Program Compliance

Observation indicating TANF/SNAP compliance

TANF Coverage Eligibility

Coverage representing TANF program eligibility

Travel for Care

Observation representing required travel for care

Treatment Program EpisodeOfCare

Episode of care for substance use treatment

Unemployment Status

Observation representing unemployment status

VA Disability Rating (%)

Observation capturing VA total disability rating percent

Veteran with VA Identifier

Patient with VA identifier for veteran example