davinci_pas_test_kit 0.15.2 → 0.16.0

data/lib/davinci_pas_test_kit/client/v2.0.1/workflows/pas_client_request_bundle_validation_test.rb

@@ -1,14 +1,16 @@
 require_relative '../../../cross_suite/pas_bundle_validation'
+require_relative '../../client_bundle_validation_helper'
 
 module DaVinciPASTestKit
   module DaVinciPASV201
     class PasClientRequestBundleValidationTest < Inferno::Test
       include DaVinciPASTestKit::PasBundleValidation
+      include DaVinciPASTestKit::ClientBundleValidationHelper
 
       id :pas_client_v201_request_bundle_validation_test
-      title 'Submit Request Bundle is valid'
+      title '$submit request Bundles have the correct structure and content'
       description %(
-        This test verifies the conformity of the client's submit request body to the
+        This test verifies the conformity of each of the PAS client's `$submit` request bodies to the
         [PAS Request Bundle](http://hl7.org/fhir/us/davinci-pas/STU2/StructureDefinition-profile-pas-request-bundle.html)
         structure. It also checks that other conformance requirements defined in the [PAS Formal
         Specification](https://hl7.org/fhir/us/davinci-pas/STU2/specification.html),
@@ -39,30 +41,22 @@ module DaVinciPASTestKit
                             'hl7.fhir.us.davinci-pas_2.0.1@81', 'hl7.fhir.us.davinci-pas_2.0.1@85',
                             'hl7.fhir.us.davinci-pas_2.0.1@86'
 
-      def workflow_tag
-        config.options[:workflow_tag]
+      def operation_name
+        'submit'
       end
 
-      def request_type_tag
-        SUBMIT_TAG
+      def message_direction_name
+        'request'
       end
 
-      run do
-        if workflow_tag.present?
-          load_tagged_requests(request_type_tag, workflow_tag)
-        else
-          load_tagged_requests(request_type_tag)
-        end
-        skip_if !request.present?, 'No submit requests received.'
+      def ig_version
+        '2.0.1'
+      end
 
-        validate_pas_bundle_json(
-          request.request_body,
-          'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle',
-          '2.0.1',
-          'submit',
-          'request_bundle',
-          message: 'The Bundle provided for the Claim/$submit operation is invalid:'
-        )
+      run do
+        failed = non_conformant_bundles
+        assert failed.empty?,
+               "Non-conformant request Bundles detected: #{failed.join(', ')}. Check messages for issues found."
       end
     end
   end

data/lib/davinci_pas_test_kit/client/v2.0.1/workflows/pas_client_response_bundle_validation_test.rb

@@ -1,21 +1,21 @@
 require_relative '../../../cross_suite/pas_bundle_validation'
 require_relative '../../user_input_response'
-require_relative '../../response_generator'
+require_relative '../../client_bundle_validation_helper'
 
 module DaVinciPASTestKit
   module DaVinciPASV201
     class PasClientResponseBundleValidationTest < Inferno::Test
       include DaVinciPASTestKit::PasBundleValidation
       include UserInputResponse
-      include ResponseGenerator
+      include DaVinciPASTestKit::ClientBundleValidationHelper
 
       id :pas_client_v201_response_bundle_validation_test
-      title 'Submit Response Bundle is valid'
+      title '$submit response Bundles have the correct structure and content'
       description %(
-        **USER INPUT VERIFICATION**: This test verifies input provided by the tester instead of the system under test.
+        This test verifies input provided by the tester instead of the PAS client.
         Errors encountered will be treated as a skip instead of a failure.
 
-        This test verifies the conformity of the submit response sent by Inferno, which will have been
+        This test verifies the conformity of each `$submit` response sent by Inferno, which will have been
         either:
         - the response body provided by the tester in the corresponding input, or
         - created by Inferno from the $submit Bundle.
@@ -33,8 +33,11 @@ module DaVinciPASTestKit
         to the bound ValueSet. Quantity, Coding, and code element bindings will
         fail if their code/system are not found in the valueset.
 
-        Note that because X12 value sets are not public, elements bound to value
-        sets containing X12 codes are not validated.
+        Note that:
+        - To ensure that the PAS client is driving its behavior only based on standard
+          PAS information, custom extensions are not allowed within the responses.
+        - Because X12 value sets are not public, elements bound to value
+          sets containing X12 codes are not validated.
 
         **Limitations**
 
@@ -46,12 +49,16 @@ module DaVinciPASTestKit
       )
       simulation_verification
 
-      def request_type
+      def operation_name
         'submit'
       end
 
-      def workflow_tag
-        config.options[:workflow_tag]
+      def message_direction_name
+        'response'
+      end
+
+      def ig_version
+        '2.0.1'
       end
 
       def target_user_input
@@ -67,26 +74,19 @@ module DaVinciPASTestKit
         end
       end
 
-      run do
-        load_tagged_requests(workflow_tag, SUBMIT_TAG)
-        skip_if requests.empty?, 'No responses to verify because no submit requests were made.'
-        message = if workflow_tag == MUST_SUPPORT_WORKFLOW_TAG
-                    'Invalid must support response bundle provided:'
-                  elsif user_inputted_response? target_user_input
-                    "Invalid response generated from provided input '#{input_title(target_user_input)}':"
-                  else
-                    'Invalid response generated from the submitted claim:'
-                  end
+      def failed_entities_description
+        if user_inputted_response? target_user_input
+          "built from tester-provided response in '#{input_title(target_user_input)}'"
+        else
+          'generated from the submitted claim'
+        end
+      end
 
-        validate_pas_bundle_json(
-          request.response_body,
-          'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle',
-          '2.0.1',
-          request_type,
-          'response_bundle',
-          skips: true,
-          message:
-        )
+      run do
+        failed = non_conformant_bundles
+        skip_if failed.present?,
+                "Non-conformant response Bundles #{failed_entities_description}: #{failed.join(', ')}. " \
+                'Check messages for issues found.'
       end
     end
   end

data/lib/davinci_pas_test_kit/client/v2.2.1/attestations/attestation_instructions.rb

@@ -0,0 +1,10 @@
+module DaVinciPASTestKit
+  module DaVinciPASV221
+    ATTESTATION_INPUT_INSTRUCTIONS = %(
+      Testers are responsible for confirming that the PAS client meets all requirements associated with a test
+      before selecting "Yes" on the attestation input with the same name as the test. The text of the
+      attested requirement(s) for each input can be reviewed by clicking the "View Specification Requirements" link
+      in the "About" tab of the test with the same name.
+    ).freeze
+  end
+end

data/lib/davinci_pas_test_kit/client/v2.2.1/attestations/client_data_element_expectations_attestation_test.rb

@@ -0,0 +1,44 @@
+require_relative 'attestation_instructions'
+
+module DaVinciPASTestKit
+  module DaVinciPASV221
+    class DataElementExpectationsAttestationTest < Inferno::Test
+      id :pas_client_v221_data_element_expectations_attestation
+      ATTESTATION_TITLE = 'PAS client does not set additional expectations for data elements'.freeze
+      title ATTESTATION_TITLE
+      description %(
+        During this test, the tester will confirm that the PAS client does not set additional expectations
+        for data elements beyond what is required by PAS.
+        To see the specifics of the attested requirements, click the "View Specification Requirements" link for this
+        test.
+      )
+      attestation
+      verifies_requirements 'hl7.fhir.us.davinci-pas_2.2.1@conf-14', 'hl7.fhir.us.davinci-pas_2.2.1@conf-15',
+                            'hl7.fhir.us.davinci-pas_2.2.1@conf-16-A'
+      input_instructions ATTESTATION_INPUT_INSTRUCTIONS
+
+      input :data_element_expectations_attestation,
+            title: ATTESTATION_TITLE,
+            description: %(
+              I attest that the PAS client does not set additional expectations for
+              data elements beyond what is required by PAS.
+            ),
+            type: 'radio',
+            default: 'false',
+            options: {
+              list_options: [
+                { label: 'Yes', value: 'true' },
+                { label: 'No', value: 'false' }
+              ]
+            }
+      input :data_element_expectations_attestation_note,
+            title: 'Notes, if applicable:',
+            type: 'textarea',
+            optional: true
+
+      run do
+        assert data_element_expectations_attestation == 'true'
+      end
+    end
+  end
+end

data/lib/davinci_pas_test_kit/client/v2.2.1/attestations/client_provider_review_attestation_test.rb

@@ -0,0 +1,45 @@
+require_relative 'attestation_instructions'
+
+module DaVinciPASTestKit
+  module DaVinciPASV221
+    class ProviderReviewAttestationTest < Inferno::Test
+      id :pas_client_v221_provider_review_attestation
+      ATTESTATION_TITLE = 'PAS client allows but does not require providers to review information before ' \
+                          'submitting'.freeze
+      title ATTESTATION_TITLE
+      description %(
+        During this test, the tester will confirm that the PAS client allows but does not require providers
+        to review submission details before sending PAS prior authorization requests.
+        To see the specifics of the attested requirements, click the "View Specification Requirements" link for this
+        test.
+      )
+      attestation
+      verifies_requirements 'hl7.fhir.us.davinci-pas_2.2.1@priv-1-A', 'hl7.fhir.us.davinci-pas_2.2.1@priv-1-B',
+                            'hl7.fhir.us.davinci-pas_2.2.1@use-5'
+      input_instructions ATTESTATION_INPUT_INSTRUCTIONS
+
+      input :provider_review_attestation,
+            title: ATTESTATION_TITLE,
+            description: %(
+              I attest that the PAS client allows but does not require providers to review
+              submission details before sending PAS prior authorization requests.
+            ),
+            type: 'radio',
+            default: 'false',
+            options: {
+              list_options: [
+                { label: 'Yes', value: 'true' },
+                { label: 'No', value: 'false' }
+              ]
+            }
+      input :provider_review_attestation_note,
+            title: 'Notes, if applicable:',
+            type: 'textarea',
+            optional: true
+
+      run do
+        assert provider_review_attestation == 'true'
+      end
+    end
+  end
+end

data/lib/davinci_pas_test_kit/client/v2.2.1/attestations/client_security_attestation_test.rb

@@ -0,0 +1,42 @@
+require_relative 'attestation_instructions'
+
+module DaVinciPASTestKit
+  module DaVinciPASV221
+    class ClientSecurityAttestationTest < Inferno::Test
+      id :pas_client_v221_security_attestation
+      ATTESTATION_TITLE = 'PAS client adheres to security and privacy requirements'.freeze
+      title ATTESTATION_TITLE
+      description %(
+        During this test, the tester will confirm that the PAS client adheres to security and
+        privacy requirements including those defined in the HRex specification. To see the specifics
+        of the attested requirements, click the "View Specification Requirements" link for this test.
+      )
+      attestation
+      verifies_requirements 'hl7.fhir.us.davinci-pas_2.2.1@spec-4'
+      input_instructions ATTESTATION_INPUT_INSTRUCTIONS
+
+      input :security_attestation,
+            title: ATTESTATION_TITLE,
+            description: %(
+              I attest that the PAS client adheres to security and
+              privacy requirements including those defined in the HRex specification.
+            ),
+            type: 'radio',
+            default: 'false',
+            options: {
+              list_options: [
+                { label: 'Yes', value: 'true' },
+                { label: 'No', value: 'false' }
+              ]
+            }
+      input :security_attestation_note,
+            title: 'Notes, if applicable:',
+            type: 'textarea',
+            optional: true
+
+      run do
+        assert security_attestation == 'true'
+      end
+    end
+  end
+end

data/lib/davinci_pas_test_kit/client/v2.2.1/attestations/client_subscription_error_recovery_attestation_test.rb

@@ -0,0 +1,42 @@
+require_relative 'attestation_instructions'
+
+module DaVinciPASTestKit
+  module DaVinciPASV221
+    class ClientSubscriptionErrorRecoveryAttestationTest < Inferno::Test
+      id :pas_client_v221_subscription_error_recovery_attestation
+      ATTESTATION_TITLE = 'PAS client can recover from Subscription errors'.freeze
+      title ATTESTATION_TITLE
+      description %(
+        During this test, the tester will confirm that the PAS client can detect and recover
+        from Subscription errors and take steps to restore notification delivery. To see the specifics
+        of the attested requirements, click the "View Specification Requirements" link for this test.
+      )
+      attestation
+      verifies_requirements 'hl7.fhir.uv.subscriptions_1.1.0@81', 'hl7.fhir.uv.subscriptions_1.1.0@82'
+      input_instructions ATTESTATION_INPUT_INSTRUCTIONS
+
+      input :subscription_error_recovery_attestation,
+            title: ATTESTATION_TITLE,
+            description: %(
+              I attest that the PAS client can detect and recover
+              from Subscription errors and take steps to restore notification delivery.
+            ),
+            type: 'radio',
+            default: 'false',
+            options: {
+              list_options: [
+                { label: 'Yes', value: 'true' },
+                { label: 'No', value: 'false' }
+              ]
+            }
+      input :subscription_error_recovery_attestation_note,
+            title: 'Notes, if applicable:',
+            type: 'textarea',
+            optional: true
+
+      run do
+        assert subscription_error_recovery_attestation == 'true'
+      end
+    end
+  end
+end

data/lib/davinci_pas_test_kit/client/v2.2.1/client_suite.rb

@@ -1,21 +1,27 @@
 require 'subscriptions_test_kit'
 require 'udap_security_test_kit'
 require 'smart_app_launch_test_kit'
+require_relative '../../cross_suite/validator_configuration'
 require_relative '../../cross_suite/validator_suppressions'
 require_relative '../../cross_suite/tags'
+require_relative '../../cross_suite/pas_constants'
 require_relative '../endpoints/claim_endpoint'
 require_relative '../endpoints/token_endpoint'
 require_relative '../endpoints/subscription_create_endpoint'
+require_relative '../endpoints/subscription_read_endpoint'
 require_relative '../endpoints/subscription_status_endpoint'
+require_relative '../endpoints/subscription_update_endpoint'
+require_relative '../endpoints/subscription_delete_endpoint'
 require_relative '../metadata/mock_pas_server'
 require_relative '../pas_client_options'
 require_relative 'pas_client_workflows_group'
 require_relative 'pas_client_must_support_group'
 require_relative 'pas_client_subscription_setup_group'
+require_relative 'pas_client_subscription_update_delete_group'
 require_relative 'pas_client_registration_group'
 require_relative 'pas_client_auth_smart_group'
 require_relative 'pas_client_auth_udap_group'
-require_relative 'pas_client_error_handling_group'
+require_relative 'pas_client_attestations_group'
 require_relative '../client_input_descriptions'
 
 module DaVinciPASTestKit
@@ -39,12 +45,12 @@ module DaVinciPASTestKit
         - [What testers need to successfully execute these tests](https://github.com/inferno-framework/davinci-pas-test-kit/wiki/Client-Instructions-v2.2.1#pre-execution-setup-and-required-information),
         - [Minimal](https://github.com/inferno-framework/davinci-pas-test-kit/wiki/Client-Instructions-v2.2.1#quick-start)
           and [complete](https://github.com/inferno-framework/davinci-pas-test-kit/wiki/Client-Instructions-v2.2.1#additional-testing-options)
-          instructions for executing against a client system, and
+          instructions for executing against a PAS client, and
         - How to [interpret test results](https://github.com/inferno-framework/davinci-pas-test-kit/wiki/Client-Instructions-v2.2.1#interpreting-results).
       DESCRIPTION
 
       suite_summary <<~SUMMARY
-        The Da Vinci PAS Client v2.2.1 Test Suite tests the conformance of client systems
+        The Da Vinci PAS Client v2.2.1 Test Suite tests the conformance of PAS clients
         to [version 2.2.1 of the Da Vinci Prior Authorization Support (PAS)
         Implementation Guide](https://hl7.org/fhir/us/davinci-pas/2.2.1).
       SUMMARY
@@ -82,12 +88,29 @@ module DaVinciPASTestKit
       )
 
       fhir_resource_validator do
-        igs('hl7.fhir.us.davinci-pas#2.2.1', 'hl7.fhir.us.core#6.1.0')
+        igs(*V221_VALIDATOR_IGS)
 
         exclude_message do |message|
-          # Messages expected of the form `<ResourceType>: <FHIRPath>: <message>`
-          # We strip `<ResourceType>: <FHIRPath>: ` for the sake of matching
-          V221_SUPPRESSED_MESSAGES.match?(message.message.sub(/\A\S+: \S+: /, ''))
+          V221_SUPPRESSED_MESSAGES.match?(message.message.sub(VALIDATOR_MESSAGE_LOCATION_PREFIX, ''))
+        end
+
+        validation_context do
+          snomedCT SNOMED_CT_US_EDITION
+        end
+      end
+
+      # Used to verify responses sent by Inferno, which may be tester-provided, to
+      # ensure they don't contain extensions not defined in the PAS IG or its dependencies.
+      fhir_resource_validator NO_CUSTOM_EXTENSIONS_VALIDATOR do
+        igs(*V221_VALIDATOR_IGS)
+
+        exclude_message do |message|
+          V221_SUPPRESSED_MESSAGES.match?(message.message.sub(VALIDATOR_MESSAGE_LOCATION_PREFIX, ''))
+        end
+
+        validation_context do
+          snomedCT SNOMED_CT_US_EDITION
+          extensions [] # no extensions not in the spec
         end
       end
 
@@ -108,6 +131,26 @@ module DaVinciPASTestKit
                      }
                    ]
 
+      # Inferno selects the first listed option by default.
+      suite_option :us_core_version,
+                   title: 'US Core Version',
+                   description: 'The US Core version whose profiles are used to validate supporting ' \
+                                'information resources that have no PAS profile.',
+                   list_options: [
+                     {
+                       label: 'US Core 3.1.1',
+                       value: PASConstants::US_CORE_VERSION_3_1_1
+                     },
+                     {
+                       label: 'US Core 6.1.0',
+                       value: PASConstants::US_CORE_VERSION_6_1_0
+                     },
+                     {
+                       label: 'US Core 7.0.0',
+                       value: PASConstants::US_CORE_VERSION_7_0_0
+                     }
+                   ]
+
       route(:get, UDAPSecurityTestKit::UDAP_DISCOVERY_PATH, lambda { |_env|
         UDAPSecurityTestKit::MockUDAPServer.udap_server_metadata(id)
       })
@@ -134,8 +177,12 @@ module DaVinciPASTestKit
       suite_endpoint :post, SESSION_INQUIRE_PATH, ClaimEndpoint
       suite_endpoint :post, FHIR_SUBSCRIPTION_PATH, SubscriptionCreateEndpoint
       suite_endpoint :post, SESSION_FHIR_SUBSCRIPTION_PATH, SubscriptionCreateEndpoint
-      suite_endpoint :get, FHIR_SUBSCRIPTION_INSTANCE_PATH, SubscriptionsTestKit::SubscriptionReadEndpoint
-      suite_endpoint :get, SESSION_FHIR_SUBSCRIPTION_INSTANCE_PATH, SubscriptionsTestKit::SubscriptionReadEndpoint
+      suite_endpoint :get, FHIR_SUBSCRIPTION_INSTANCE_PATH, SubscriptionReadEndpoint
+      suite_endpoint :put, FHIR_SUBSCRIPTION_INSTANCE_PATH, SubscriptionUpdateEndpoint
+      suite_endpoint :delete, FHIR_SUBSCRIPTION_INSTANCE_PATH, SubscriptionDeleteEndpoint
+      suite_endpoint :get, SESSION_FHIR_SUBSCRIPTION_INSTANCE_PATH, SubscriptionReadEndpoint
+      suite_endpoint :put, SESSION_FHIR_SUBSCRIPTION_INSTANCE_PATH, SubscriptionUpdateEndpoint
+      suite_endpoint :delete, SESSION_FHIR_SUBSCRIPTION_INSTANCE_PATH, SubscriptionDeleteEndpoint
       suite_endpoint :post, FHIR_SUBSCRIPTION_INSTANCE_STATUS_PATH, SubscriptionStatusEndpoint
       suite_endpoint :post, SESSION_FHIR_SUBSCRIPTION_INSTANCE_STATUS_PATH, SubscriptionStatusEndpoint
       suite_endpoint :get, FHIR_SUBSCRIPTION_INSTANCE_STATUS_PATH, SubscriptionStatusEndpoint
@@ -177,7 +224,8 @@ module DaVinciPASTestKit
         PASClientOptions.recursive_remove_input(self, :session_url_path)
         config(inputs: { client_id: { optional: false } })
       end
-      group from: :pas_client_v221_error_handling_group, id: :pas_client_v221_error_handling_smart do
+      group from: :pas_client_v221_subscription_update_delete,
+            id: :pas_client_v221_subscription_update_delete_smart do
         required_suite_options client_type: PASClientOptions::SMART_BACKEND_SERVICES_CONFIDENTIAL_ASYMMETRIC
         PASClientOptions.recursive_remove_input(self, :session_url_path)
         config(inputs: { client_id: { optional: false } })
@@ -199,7 +247,8 @@ module DaVinciPASTestKit
         PASClientOptions.recursive_remove_input(self, :session_url_path)
         config(inputs: { client_id: { optional: false } })
       end
-      group from: :pas_client_v221_error_handling_group, id: :pas_client_v221_error_handling_udap do
+      group from: :pas_client_v221_subscription_update_delete,
+            id: :pas_client_v221_subscription_update_delete_udap do
         required_suite_options client_type: PASClientOptions::UDAP_CLIENT_CREDENTIALS
         PASClientOptions.recursive_remove_input(self, :session_url_path)
         config(inputs: { client_id: { optional: false } })
@@ -221,7 +270,8 @@ module DaVinciPASTestKit
         PASClientOptions.recursive_remove_input(self, :client_id)
         config(inputs: { session_url_path: { optional: false } })
       end
-      group from: :pas_client_v221_error_handling_group, id: :pas_client_v221_error_handling_no_auth do
+      group from: :pas_client_v221_subscription_update_delete,
+            id: :pas_client_v221_subscription_update_delete_no_auth do
         required_suite_options client_type: PASClientOptions::OTHER_AUTH
         PASClientOptions.recursive_remove_input(self, :client_id)
         config(inputs: { session_url_path: { optional: false } })
@@ -235,6 +285,8 @@ module DaVinciPASTestKit
             required_suite_options: {
               client_type: PASClientOptions::UDAP_CLIENT_CREDENTIALS
             }
+
+      group from: :pas_client_v221_attestations
     end
   end
 end

data/lib/davinci_pas_test_kit/client/v2.2.1/error_handling/pas_client_operation_failure_submit_test.rb

@@ -14,7 +14,7 @@ module DaVinciPASTestKit
       id :pas_client_v221_operation_failure_submit_test
       title 'PAS client submits a claim and receives an OperationOutcome response'
       description %(
-        Inferno will wait for a prior authorization submission request from the client.
+        During this test, Inferno will wait for a prior authorization submission request from the PAS client.
         Upon receipt, Inferno will return the provided OperationOutcome with the configured
         HTTP status code (default 400).
       )
@@ -23,8 +23,8 @@ module DaVinciPASTestKit
             title: 'Operation Failure OperationOutcome JSON',
             type: 'textarea',
             description: %(
-              Inferno will return this OperationOutcome JSON in response to the $submit request
-              during this test.
+              Inferno will return exactly this OperationOutcome JSON in response
+              to the $submit request during the *Operation Failure* group.
             )
       input :operation_failure_http_status,
             title: 'Operation Failure HTTP Status Code',
@@ -32,8 +32,10 @@ module DaVinciPASTestKit
             optional: true,
             default: '400',
             description: %(
-              The HTTP status code Inferno will use when returning the OperationOutcome to the client.
-              Must be a 4XX or 5XX value. Defaults to 400 if not provided or outside that range.
+              The HTTP status code Inferno will use when returning the Operation Failure
+              OperationOutcome to the PAS client. If provided, the value must be in the 4XX or
+              5XX range. Inferno will return 400 if this input is not provided or the
+              provided value is outside that range.
             )
       input :client_id,
             title: 'Client Id',
@@ -49,6 +51,7 @@ module DaVinciPASTestKit
             description: INPUT_SESSION_URL_PATH_LOCKED
 
       submit_respond_with :operation_failure_operation_outcome
+      config options: { submit_enabled: true }
 
       run do
         assert_valid_json operation_failure_operation_outcome,
@@ -59,16 +62,23 @@ module DaVinciPASTestKit
 
         wait(
           identifier: wait_identifier,
-          message: %(
-            **Operation Failure Workflow Test**:
+          message: <<~MESSAGE
+            **Operation Failure Scenario Test**:
+
+            Inferno will wait while the tester uses the PAS client to submit a PAS request to
+            Inferno. Inferno will respond with exactly the provided OperationOutcome and HTTP status.
+            The tests will automatically continue once a request has been received.
+
+            ### Endpoints
 
             Submit a PAS request to
 
             `#{submit_endpoint}`
 
-            Inferno will respond with the provided OperationOutcome and HTTP status
-            **#{operation_failure_http_status.present? ? operation_failure_http_status : '400'}**.
-          )
+            ### Authentication and Identification
+
+            #{auth_description_for_wait(client_id)}
+          MESSAGE
         )
       end
     end

data/lib/davinci_pas_test_kit/client/v2.2.1/error_handling/pas_client_operation_outcome_validation_test.rb

@@ -1,4 +1,5 @@
 require_relative '../../../cross_suite/tags'
+require_relative '../../../cross_suite/validator_configuration'
 
 module DaVinciPASTestKit
   module DaVinciPASV221
@@ -7,10 +8,14 @@ module DaVinciPASTestKit
       title 'Response OperationOutcome has the correct structure and content'
       description %(
         This test verifies the validity of the OperationOutcome returned by Inferno during the
-        Operation Failure workflow. The OperationOutcome is validated against the base FHIR R4
+        Operation Failure scenario. The OperationOutcome is validated against the base FHIR R4
         OperationOutcome resource definition — no PAS-specific profile is required.
 
-        Per IG §7.2.5, when a 4XX response is returned, an OperationOutcome SHALL be included
+        To ensure that the PAS client is driving its behavior only based on standard
+        PAS information, custom extensions are not allowed within the response.
+
+        The PAS IG [requires](https://hl7.org/fhir/us/davinci-pas/2.2.1/en/specification.html#prior-authorization-transaction-error-handling)
+        that when a 4XX response is returned, an OperationOutcome **SHALL** be included
         that details why the bundle could not be processed.
       )
       simulation_verification
@@ -29,9 +34,10 @@ module DaVinciPASTestKit
         skip_if !operation_outcome.is_a?(FHIR::OperationOutcome),
                 "Expected an OperationOutcome but received #{operation_outcome.resourceType}."
 
-        skip_if !resource_is_valid?(resource: operation_outcome),
-                'The OperationOutcome returned during the Operation Failure workflow is not conformant ' \
-                'with the base FHIR R4 OperationOutcome resource definition.'
+        skip_if !resource_is_valid?(resource: operation_outcome, validator: NO_CUSTOM_EXTENSIONS_VALIDATOR),
+                'The OperationOutcome returned during the Operation Failure scenario is not conformant ' \
+                'with the base FHIR R4 OperationOutcome resource definition or contains custom extensions. ' \
+                'See Messages for details.'
       end
     end
   end