1. Provider Directories Meeting Presented By Alan Viars and Richard Gilbert June 19, 2014 NPPES Modernization Project

2. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. What is NPPES? NPPES Provides Individuals and Healthcare Organization a unique identifier for healthcare transactions - an NPI NPI records are based on self reported (unverified), information. Nearly all payers require providers and suppliers to have an NPI. NPPES manages over 4 Million NPIs, and tens of thousands of updates per month. 01/28/2014 2

3. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. HHS Entrepreneurs 01/28/2014 3 Program Goal: Attract entrepreneurial talent to work with HHS staff on high-risk, high-reward projects for 13 months To Date: 9 Projects (from 2 cohorts), 6 Operating and Staff Divisions (ASPA, ASPR, ONC, ACF, CMS, HRSA), 12 External Entrepreneurs, and 29 Internal Entrepreneurs

4. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. NPPES Modernization - Goal The goal for NPPES Modernization Project is to improve provider data quality, consistency, and usability for CMS, HHS, and the public. 4 01/28/2014

5. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. Problem Primary information in NPPES, such as provider’s practice addresses and telephone numbers are out of date. Providers have little to no incentive to update his or her record. The result is “staleness” of the data. Data accessibility and consistency issues exist amongst CMS systems. 5 01/28/2014

6. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. Project Objectives Collect input and feedback from internal stakeholders, providers, data consumers. Improve data quality in existing system Develop a web service for internal and external users. Develop a new fully-functional system of NPPES that makes providers want to keep their data current. 6 01/28/2014

7. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. High -Level Architecture Web Site – The new prototype system based on modern web stack using a 3-tier architecture where database access, control logic, and display logic are separated. Develop a framework for managing all provider-like enumerations (NPI, HPID, OEID, etc.). Create a series of “micro-services” that can be used for reporting and as well as data feeds for other applications. (e.g. a way for PECOS to fetch addresses, taxonomies, identifiers, and other information from NPESS). 7 01/28/2014

8. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. Existing System Snapshot A circa 2000 technology stack – No major technology refresh or user interface overhaul since inception. – Tied to outdated web technology. – Complicated, expensive, and difficult to change. – No simple method for system to system connectivity. 8 01/28/2014

9. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. New Website and Data Service Snapshot A contemporary open source technology stack – Mobile ready – Uses a responsive design to adapt to smartphone, tablet, or desktop computers. – Designed on technology used to run some of the webs largest sites. – A RESTFul API – Streamlined interface functionality to maintain large numbers of provider records. 9 01/28/2014

10. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. Challenges and Obstacles Access to server space for development, testing, and production within CMS. Interfacing with existing systems (e.g. I&A, PECOS). Network and system constraints slowing and complicating the development process. 10 01/28/2014

11. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. RESTFul API Using a GeoJSON-like approach Based around a JSON document that contains all necessary provider info. Can be expanded and contain extra information as needed. 01/28/2014 11

12. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. Pseudo JSON Example { number: 123456789, type: "NPI-1", basic: { first_name: "Ada", last_name:"Lovelace",... }, addresses:[...], taxonomies[...], licenses:[...], identifiers:[...], direct_addresses:[...] } 01/28/2014 12

13. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. Launch Plan Transition Plan Prototype Updates Timeline 13 01/28/2014 Community / Stakeholder Feedback PrototypeConcept January 2014 April 2014 July 2014 October 2014 December 2014

14. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. Prototype Screenshots 14 01/28/2014 (Draft Images / Work In Progress)

15. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. More Information Check out http://npi.iohttp://npi.io We are conducting stakeholder interviews by phone to collect requirements. The project is open source. We will accept pull requests. 01/28/2014 15

16. INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law. Questions 01/28/2014 16