Automating & standardizing medical license verification

[Alan Viars]

As part of my work here at CMS I've learned a bit about medical license verification.  Currently NPPES has no automated license verification system.  Its a difficult problem because each state has their own way of doing things.

As Eric on this list pointed out, there is not standard way to reference a license. 

To this end I've built up a project called "Medical License Verification Specification" or MLVS.  It attempts to standardize how licenses are identified, hence benefiting the health care industry, CMS, and the general public by making this information more readily available.  

Eric's comments spurred me to make some changes to what was previously outlined.  I've also included a CSV (in the repository under the docs) that contains three letter codes for different types of credentials.

The details are outlined in the README within this repository: https://github.com/HHSIDEAlab/mlvs .  

Of course, state medical boards would need to actually to adopt this specification (or the information could be imported using existing sources).  It is quite simple so "the ask" is not that great.

We are seeking feedback on this proposal. Does this make sense? Please forward to this to any contacts at state medical boards.

Sincerely,

Alan Viars

[eric_...@jsi.com]

I will note that nothing is a simple ask when it comes to state licensing boards in general, though I think technically this request is.  That is why I suggested potentially connecting this to the Minimum Data Set initiative in some way as there are parallels in terms of bringing standardization to the system.  Providing lists of providers is not often seen as a core function - they manage the licensing process but are often primarily focused on reviewing practice issues and dealing with suspensions, etc.  To that end I will note that it might be good to include a "license status" field so that is it possible to list all providers even if their license is not in an active status.

[fred trotter]

This is a good idea. Should we be publicizing this?

-FT

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[eric_...@jsi.com]

I think I had mentioned this in another thread along the way but one thought might be to bring this up with the folks at HRSA's Natl. Center for Health Workforce Analysis related to their Minimum Data Set initiative - see: http://bhpr.hrsa.gov/healthworkforce/data/minimumdataset/index.html  As states work to standardize and coordinate their health workforce data, participating in a tool like this could help spread/broaden the vaule of what is being done.  ET

[Alan Viars]

Actually next year in Cohort 3 of HHS Entrepreneurs there is a joint project between CMS and HRSA to create a national credential portal.

http://www.hhs.gov/idealab/innovate/healthcare-practitioner-credentialing-portal/

I'd be honored if this work was considered as the foundation.

Alan Viars

[Darrell DeVeaux]

Actually, I think this will be a heavier lift then mentioned because many states now charge a fair amount to get a file of active provider licenses. If they are standardized and available from NPPES (and of course if NPPES data is up to date which is another story) then this revenue source goes away.

Yes, you can often look up an individual number for free, but I am referring to the entire set.

On Tuesday, March 11, 2014 3:40:57 PM UTC-4, Alan Viars wrote:

[Greg]

is the NPDB related to this at all? I know they are more geared towards checking sanctions on providers license but would they not already have a database of licenses at the national level?
- The National Practitioner Data Bank (NPDB)

Also wouldn't the National Committee for Quality Assurance (NCQA) have an interest in seeing a national database? It says right on their 'About' page that part of their mission is "leveraging the Web to give consumers more information"

Credentialing Fact Sheet

http://www.ncqa.org/Portals/0/Newsroom/2014/CredentialingFactSheetFinal.pdf

[Darrell DeVeaux]

The discussion might be a little outdated now as I'm sure Alan has done something since original discussion. But yes the discussion was related to both of these but NPDB charges a fair amount for this information and don't think they would want to give up that revenue stream.