mapper-leie

⛔ Deprecated

Overview

The U.S. Department of Health and Human Services, Office of Inspector General's List of Excluded Individuals/Entities (LEIE) provides information to the health care industry, patients and the public regarding individuals and entities currently excluded from participation in Medicare, Medicaid, and all other Federal health care programs.

The leie-mapper.py python script converts this list into a json file ready to load into Senzing. This list is available to the public and can be downloaded here.

The list of exclusion types can be found here and their FAQ can be found here.

Loading this data into Senzing requires additional features and configurations. These are contained in the leie_config_updates.g2c file.

Usage:

python3 leie-mapper.py --help
usage: leie-mapper.py [-h] [-i INPUT_FILE] [-o OUTPUT_FILE] [-l LOG_FILE]

optional arguments:
  -h, --help            show this help message and exit
  -i INPUT_FILE, --input_file INPUT_FILE
                        the name of the input file
  -o OUTPUT_FILE, --output_file OUTPUT_FILE
                        the name of the output file
  -l LOG_FILE, --log_file LOG_FILE
                        optional name of the statistics log file

Contents

1. Prerequisites
2. Installation
3. Configuring Senzing
4. Running the mapper
5. Loading into Senzing
6. Mapping other data sources

Prerequisites

• Python 3.6 or higher

Installation

Place the following files on a directory of your choice:

• leie_mapper.py
• leie_config_updates.g2c

Configuring Senzing

Note: This only needs to be performed one time! In fact you may want to add these configuration updates to a master configuration file for all your data sources.

From your Senzing project directory:

python3 G2ConfigTool.py <path-to-file>/leie_config_updates.g2c

This will step you through the process of adding the data sources, features, attributes and any other settings needed to load this watch list data into Senzing. After each command you will see a status message saying "success" or "already exists". For instance, if you run the script twice, the second time through they will all say "already exists" which is OK.

Running the mapper

Download the raw file from: here

There you can download the complete and updated list as well as monthly additions and reinstatements. All 3 files have the same structure. The full file is small enough that you can map and load the whole file every time and Senzing will not duplicate records. But you do have the option of just loading the full file once and only applying the monthly updates thereafter.

Then run the mapper. Example usage:

python3 leie_mapper.py -i /path/to/leie-updated-yyyy-mm-dd.csv -o /path/to/leie-full-yyyy-mm-dd.json

Loading into Senzing

If you use the G2Loader program to load your data, from your project directory ...

python3 G2Loader.py -f /path/to/leie-full-yyyy-mm-dd.json

This data set currently only contains about 75k records and loads in just a few minutes on decent hardware.

Mapping other data sources

While not required, look for the following identifiers in your other data sets:

• NPI_NUMBER - The NPI (National Provider Identifier) has replaced the UPIN (see question below) as the unique number used to identify health care providers. The Centers for Medicaid & Medicare Services first began assigning NPIs in 2006, and providers were required to use NPIs as of mid-2008.
• UPIN_NUMBER - The UPIN (Unique Physician Identification Number) was established by the Centers for Medicare & Medicaid Services as a unique provider identifier in lieu of the SSN. UPINs were assigned to physicians as well as certain non-physician practitioners and medical group practices. CMS no longer maintains the UPIN registry.

Note: The Downloadable Database does not contain SSNs or EINs. Therefore, verification of specific individuals or entities through the use of the SSN or EIN must be done via the Online Searchable Database.