>>>How can you possibly prove that?
>
>How can you possibly prove your version? This is not SQL Server where you can look it up and confidently offer a solution, all of these considerations are peered at through a glass darkly. In my case I've been privileged to be involved in more than one healthcare system in times of change, and right now the US is in the middle of a change with insurers, providers and legislators finding their way.
I don't need to prove it. Your last sentence did it for me.