This project uses the NPPES API to load data into a Mongo DB.

Load NPPES and Taxonomy data into PostgreSQl and Oracle

NPI_Search_MSSQL_PHP

NPPES CSV Import and Sanitation Project - PHP, Symfony4, MySQL

NPPES NPI + Postgres

Medicare Provider and Supplier Taxonomy Crosswalk

CROSSWALKMEDICARE PROVIDER/SUPPLIER to HEALTHCARE PROVIDER TAXONOM

If your taxonomy code is invalid or your taxonomy indicates you do not have the right to prescribe certain drugs, pharmacies using Express Scripts, Inc. (ESI)—our primary pharmacy network—will not fill your patients’ prescriptions.

The Complete History of the NPI Number The National Provider Identifier (NPI) is an under-appreciated marvel of the modern healthcare system.

NPI Fact SheetF o r H e a l t h C a r e P r o v i d e r sW h o A r e S o l e P r o p r i e t o r s

Part D plans must submit an electronic record, called a PDE record, toCMS for each covered prescription filled for their enrollees. CMSrequires that most PDE records contain an identifier for the drug’sprescriber. Acceptable prescriber identifiers include National ProviderIdentifiers (NPI), Drug Enforcement Administration (DEA) registrationnumbers, Unique Physician Identification Numbers (UPIN), and Statelicense numbers

US Department of Health and Human ServicesPrivacy Impact AssessmentDate Signed:12/22/2016OPDIV:CMSName:National Plan and Provider Enumeration System

National Standard Health CareProvider IdentifierAGENCY : Health Care FinancingAdministration (HCFA), HHS.ACTION: Proposed rule.SUMMARY : This rule proposes a standardfor a national health care provideridentifier and requirements concerningits use by health plans, health careclearinghouses, and health careproviders.

the same name andNational Provider Identifier (NPI) (asrequired to be reported in this final rule)should be used consistently for allpayment lines and any subsequentupdates for the same individual.

The name of the covered recipient.‘‘(ii) The business address of the covered recipientand, in the case of a covered recipient who is a physi-cian, the specialty and National Provider Identifierof the covered recipient.‘‘(iii) The amount of the payment or other transferof value.‘‘(iv) The dates on which the payment or othertransfer of value was provided to the covered recipient.‘‘(v) A description of the form of the payment orother transfer of value, indicated (as appropriate forall that apply) as—‘‘(I) cash or a cash equivalent;‘‘(II) in-kind items or services;‘‘(III) stock, a stock option, or any other owner-ship interest, dividend, profit, or other return oninvestment; or‘‘(IV) any other form of payment

Department of Health and Human ServicesOFFICE OFINSPECTOR GENERALMPROVEMENTS EEDED TOE NSURE P ROVIDERE NUMERATION AND MEDICAREENROLLMENT DATA AREACCURATE , C OMPLETE , ANDONSISTENTDaniel R. LevinsonInspector GeneralMay 2013OEI-07-09-00440I NC

Of the 10,504 locations reviewed, providers should not have been listed at 33.14% (3,481) of thelocations (2,088 + 1,393, as shown in Table 5) either because the provider did not work at thelocation or because the provider did not accept the plan at the location. In 1,393 of theseinstances, the provider should not have been listed at any of the locations in the directory. Therewere 690 phone numbers that were wrong or disconnected and 364 incorrect addresses. Finally,there were 221 instances in which the provider was found not to be accepting new patients,although the directory indicated that the provider was accepting new patients. Table 5 provides abreakdown of deficiencies identified by CMS during the review process.

In accordance with the NPPES Data DisseminationNotice (CMS-6060), published May 30, 2007, certain information that you furnish will be publicly disclosed. The NPPES DataDissemination Notice can be found at https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/Downloads/NPPES_FOIA_Data-Elements_062007.pdf.

NATIONAL PROVIDER IDENTIFIER (NPI) APPLICATION/UPDATE FORM

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce theavailability of a new identifier for use in the standard electronic health care transactions.The National Provider Identifier (NPI) will be the single provider identifier, replacir1g thedifferent provider identifiers you currently use for each health plan with which you dobusiness.

The NCVHS has been briefed on theproposal for the National Provider Identifier(NPI), and we offer our strong support.

In the January 23, 2004 Federal Register (69 FR 3434), the U.S. Department of Health and Human Services (HHS) published a final rule establishing the standard for a unique health identifier for health care providers for use in the health care system and adopting the National Provider Identifier (NPI) as that standard (“2004 NPI final rule”). The rule also established the implementation specifications for obtaining and using the NPI. Since that time, pharmacies have encountered situations where they need to include the NPI of a prescribing health care provider in a pharmacy claim, but where the prescribing health care provider has been a noncovered health care provider who did not have an NPI because he or she was not required to obtain one. This situation has become particularly problematic in the Medicare Part D program. The addition to the NPI requirements addresses this issue.

SORN 09-70-0555 System Name: National Plan and Provider Enumeration System" (NPPES), HHS/CMS/OFM.

Privacy Act of 1974; System of Records A Notice by the Health and Human Services Department on 02/14/2018

Privacy Act of 1974; Report of a New Routine Use for Selected CMS Systems of Records A Notice by the Centers for Medicare & Medicaid Services on 05/29/2013

newsystem of records, called the ‘‘NationalProvider System (NPS),

modify or alter existing system of records titled “National Provider System,” System No. 09-70-0008

HIPAA Administrative Simplification: National Plan and Provider Enumeration System Data Dissemination

HIPAA Administrative Simplification: National Plan and Provider Enumeration System Data Dissemination

National Provider Identifier Standard (NPI): Educational Resources

Medicare NPI Implementation

National Plan and Provider Enumeration System (NPPES) Data Changes

HIPAA Administrative Simplification:Standard Unique Health Identifier forHealth Care Providers

Prescription Drug Monitoring Program (PDMP)

n New Year’s Day 2020, I was zipping up my fleece to head outside when the phone in the kitchen rang. I picked it up to find a reporter on the line. “Dr. Fauci,” he said, “there’s something strange going on in Central China. I’m hearing that a bunch of people have some kind of pneumonia. I’m wondering, have you heard anything?”

HRSA MADE COVID-19UNINSURED PROGRAMPAYMENTS TO PROVIDERS ONBEHALF OF INDIVIDUALS WHOHAD HEALTH INSURANCECOVERAGE AND FOR SERVICESUNRELATED TO COVID-19

Protected health informationmeans individually identifiablehealth information:(1) Except as provided inparagraph (2) of this definition,that is:(i) Transmitted by electronicmedia;(ii) Maintained in electronicmedia; or(iii) Transmitted or maintainedin any other form or medium.

Individually identifiable healthinformation is information thatis a subset of health information,including demographicinformation collected from anindividual, and:(1) Is created or received by ahealth care provider, health plan,employer, or health careclearinghouse; and(2) Relates to the past, present,or future physical or mentalhealth or condition of anindividual; the provision ofhealth care to an individual; orthe past, present, or futurepayment for the provision ofhealth care to an individual; and(i) That identifies the individual;or(ii) With respect to which thereis a reasonable basis to believethe information can be used toidentify the individual

ii) A person that offers apersonal health record to one ormore individuals on behalf of acovered entity

February 25 telebriefing

On February 9,2020, using publicly available data, a senior health official from the U.S. Department of VeteransAffairs warned key senior officials that COVID-19 was more transmissible and deadlier thanH1N1 and the U.S. was only a “couple of weeks” behind the spread in China

In its February 24, 2020supplemental funding request, the Office of Management and Budget wrote, “[t]o this point, noagency has been inhibited in response efforts due to resources or authorities.

The Strategic National Stockpile distributed the last of its PPE held for states on April 19,2020—the same day it made the decision to begin allocating PPE based on need, not population.

in May 2020 when the federal governmentdecided to extend a one-year federal PPE contract to that same PPE manufacturer, the companydeclined the contract offer

When one domestic PPE manufacturer sent multiple warnings and requests toramp up U.S. production throughout the months of January, February, and March 2020, thefederal government declined to engage

conflicting internal accounts of not only whatwent wrong, but also the reasons for those failures

. Ultimately, the Trump Administration waited until March16, 2020—fifty-five days from the date of the first confirmed case—to implement its first widescale attempt at nationwide mitigation of viral spread.

Alex Azar declared a public health emergency

as early as mid-December 2019

initiating export bans on personalprotective equipment (PPE

identified rapid construction of a new 1,000 bed hospital in Wuhan,

U.S. Department of Health andHuman Services’ (HHS) Centers for Disease Control and Prevention (CDC) learned of anemerging novel pathogen, now known as SARS-CoV-2

Over the last 10 years, we’ve lost 360,000.  These are people that have died from the flu — from what we call the flu.  “Hey, did you get your flu shot?”  And that’s something.

The Johns Hopkins, I guess — is a highly respected, great place — they did a study, comprehensive: “The Countries Best and Worst Prepared for an Epidemic.”  And the United States is now — we’re rated number one.  We’re rated number one for being prepared

1 United States

proprietary information of such manufacturer (as determined by the Secretary)

A list of data the agency intends to collect, use, oracquire to facilitate the use of evidence in policymaking.

Concurring Statement of Commissioner Christine S. Wilson

we admit no wrongdoing

protecting our users’ privacy is one of our most important priorities

confidentiality provisions in place

primarily IP addresses and web page URL information related to looking at content

We are thoughtful and disciplined about what information we gather and how and why we use it.

You can view the full terms of the settlement

These statements are neither promises nor guarantees

While we may elect to update such forward-looking statements at some point in the future, we disclaim any obligation to do so, even if subsequent events cause our views to change.

We’ve worked hard to earn that trust.

GoodRx is a leader on data privacy.

No medical records were shared.

No medical records were shared.

The Facebook pixel continues to be used by many websites on the Internet, including U.S. Government websites, insurance companies, hospitals and others.

At that time, we also added a number of new, industry-leading ways for consumers to protect their privacy, including an option to request the deletion of personal data.

took action to be an industry leader on privacy practices

to advertise in a way that we believe was compliant

proactively made updates

GoodRx is not a HIPAA-covered entity

GoodRx issued a public response

GoodRx also did not have any employee, manager, executive, or team formallydedicated to the management or oversight of GoodRx’s company-wide privacy and data sharingpractices

Rather, GoodRx agreed to each of these thirdparties’ standard terms of service, or entered into agreements that permitted each AdvertisingPlatform to use GoodRx users’ personal health information expansively, including for otheradvertising or for their own internal business purposes

In August 2019, HeyDoctor began prompting users to view a GoodRx Coupon formedications prescribed during their telehealth consultation. When a user did so, GoodRxconfigured the pixel to share information about the prescribed medication with Facebook,through a Custom Event called “drug.” It shared the medication name (such as “nitrofurantoin”);dosage (such as “100 mg”); form (such as “capsule”); whether the user was interested in viewingthe GoodRx Coupon (such as “interested: Yes”); and the name and location of the users’pharmacy (such as “Pharmacy: Capsule Pharmacy, New York, NY”). The pixel also sharedusers’ IP address, and website microdata with additional information about the prescriptionmedication and health condition(s) for which users accessed GoodRx Coupons.

This included the name of the medication for which users accessed aGoodRx Coupon (“Drug Name,” such as “Lipitor”); the website URL, which in many casesincluded a medication name; the health condition related to the medication (“Drug Category,”such as “high cholesterol”); the medication quantity (“Drug Quantity,” such as “30-day supply”);the pharmacy name (“PharmName”); and the user’s city, state and zip code. The pixel alsocollected website microdata with additional information about the prescription medication andhealth condition(s) for which users accessed GoodRx Coupons. Finally, the pixel collectedusers’ IP addresses.

For example, GoodRx created Custom Events with names like“Drug Name” and “Drug Category” that tracked and shared the prescription medication nameand health condition(s) associated with each unique GoodRx Coupon that users accessed

GoodRx displayed a seal at thebottom of the HeyDoctor homepage

GoodRx’s privacy policy representations described above were false anddeceptive. In fact, since 2017, GoodRx has shared its users’ personal and health informationwith Advertising Platforms and other third parties in violation of its promises, including fortargeted advertising, without providing notice or obtaining affirmative express consent.

[a]ny information we do receive is stored under the same guidelines as any healthentity.

Sensitive Data Principle

Digital Advertising Alliance principles

Digital Advertising Alliance(“DAA”)

However, we never provide advertisers or any other third parties any information thatreveals a personal health condition or personal health information.1

GoodRx receives a portion of a feethat pharmacies pay to PBMs when users purchase medications using GoodRx Coupons

labeled them bythe medication they had purchased

Case No. 23-cv-460

Until a consumer watchdog publicly revealedGoodRx’s actions in February 2020,

The Sensitive Data Principle

GoodRx adheres to Digital Advertising Alliance principles.

Case No. 3:23-cv-460

No, HIPAA Doesn't Apply

The Federal Trade Commission has taken enforcement action for the first time under its Health Breach Notification Rule against the telehealth and prescription drug discount provider GoodRx

Law Enforcement Purposes. Covered entities may disclose protected health information to law enforcement officials for law enforcement purposes under the following six circumstances, and subject to specified conditions: (1) as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; (2) to identify or locate a suspect, fugitive, material witness, or missing person; (3) in response to a law enforcement official’s request for information about a victim or suspected victim of a crime; (4) to alert law enforcement of a person’s death, if the covered entity suspects that criminal activity caused the death; (5) when a covered entity believes that protected health information is evidence of a crime that occurred on its premises; and (6) by a covered health care provider in a medical emergency not occurring on its premises, when necessary to inform law enforcement about the commission and nature of a crime, the location of the crime or crime victims, and the perpetrator of the crime.34

The previous methodology assigns beneficiaries in two steps based on the plurality of primary care services furnished 1) by primary care physicians, and 2) by specialist physicians, nurse practitioners, physician assistants, and clinical nurse specialists.     In the final rule, we are revising the assignment methodology to remove certain specialty types whose services are not likely to be indicative of primary care services from Step 2, which places greater emphasis on primary care physicians.  Additionally, we will include primary care services furnished by nurse practitioners, physician assistants, and clinical nurse specialists in Step 1 to recognize the primary care delivered by these professionals. Finally, through rulemaking in the 2017 Physician Fee Schedule, we expect to propose that beneficiaries may attest that their main doctor is participating in a performance-based risk track ACO and be assigned to that ACO.

A) Yes. If charitable organizations participate in the Shared Savings Program through an ACO along with private parties, the charitable organization must be sure that it continues to meet the requirements for tax exemption to avoid adverse tax consequences. For example, its participation must: not result in its net earnings inuring to the benefit of private shareholders or individuals, and not result in its being operated for the benefit of private parties participating in the ACO. The IRS determines whether prohibited inurement or impermissible private benefit has occurred based on all the facts and circumstances.

Requirements.—An ACO shall meet the following requirements:

In 2000, Seisint Inc. (now LexisNexis Group) developed a C++-based distributed file-sharing framework for data storage and query. The system stores and distributes structured, semi-structured, and unstructured data across multiple servers.