Fonteum Data Glossary

The 340B Drug Pricing Program is a federal program established under Section 340B of the Public Health Service Act that requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at significantly reduced prices — up to 50% below market — to qualifying covered entities. Covered entities include Federally Qualified Health Centers, children's hospitals, Ryan White HIV/AIDS Program grantees, disproportionate-share hospitals, and other safety-net providers. In exchange, 340B entities must serve high proportions of low-income or uninsured patients. HRSA administers the 340B program and publishes the database of all registered covered entity sites. As of 2024, over 50,000 covered entity sites participate.

8(a) certification is the U.S. Small Business Administration's determination that a small business is eligible to participate in the 8(a) Business Development program. The program is governed by 13 CFR Part 124 and supports eligible small disadvantaged businesses through business-development assistance and access to 8(a) set-aside and sole-source federal contracting opportunities during a maximum nine-year term.

The 8(a) Business Development Program is a U.S. Small Business Administration program that helps small businesses owned by socially and economically disadvantaged individuals compete for federal contracts. Named for Section 8(a) of the Small Business Act, it offers a nine-year term of training, mentoring, and access to sole-source and set-aside awards. A debarment or exclusion can end eligibility.

The Australian Business Number is the Australian Business Register identifier used by businesses and organizations that deal with government, invoice customers, or operate an enterprise in Australia. It can belong to many structures, including companies, sole traders, partnerships, trusts, super funds, and charities. For company-register work, ABN is read alongside the ASIC-issued ACN so tax-facing business identity is not confused with the registered-company identifier.

The Australian Business Number is maintained through the Australian Business Register and can be held by companies, sole traders, partnerships, trusts, and other organizations carrying on an enterprise. The Australian Company Number is assigned by ASIC only to companies registered under the Corporations Act. In entity-resolution work, ABN is the wider business identifier and ACN is the company-registration identifier.

The Australian Company Number is assigned by the Australian Securities and Investments Commission to each registered Australian company. It is the company-register identifier, used on ASIC records and corporate documents. ACN should not be treated as a substitute for ABN: the ACN identifies the registered company, while the ABN identifies the wider business or organization for tax, invoicing, and government dealings.

An Accountable Care Organization (ACO) is a group of doctors, hospitals, and other health care providers who voluntarily coordinate care for Medicare beneficiaries with the goal of delivering high-quality, efficient care. ACOs accept accountability for total cost and quality of care for an attributed patient population. Under the Medicare Shared Savings Program (MSSP), ACOs that reduce spending below a benchmark while meeting quality thresholds share in the savings. CMS administers multiple ACO models; in 2024, ACOs served over 11 million Medicare beneficiaries.

The AHRQ Patient Safety Indicators (PSIs) are a set of quality measures developed by the Agency for Healthcare Research and Quality that use hospital inpatient administrative data to identify potentially preventable complications and adverse events associated with hospital care. PSIs are calculated from ICD-coded discharge data using AHRQ-supplied software. Indicators cover complications of surgery, hospital-acquired conditions, and adverse events during hospitalization — including pressure ulcers, postoperative respiratory failure, accidental puncture or laceration, and transfusion reactions. AHRQ maintains PSI technical specifications; CMS incorporates select PSIs into hospital quality reporting programs including the Hospital Inpatient Quality Reporting (IQR) program and Care Compare.

An Ambulatory Surgical Center (ASC) is a Medicare-certified health care facility that provides surgical services to patients who do not require hospitalization. CMS certifies ASCs under Conditions for Coverage and reimburses them under the ASC Payment System. CMS publishes quality and performance data for over 5,600 Medicare-certified ASCs through the Care Compare ASC dataset. Common ASC procedures include cataract surgery, colonoscopies, and orthopedic procedures. ASCs collectively perform more than 23 million procedures annually in the United States.

ASIC is Australia's corporate regulator and register authority. Fonteum's `australia-asic` source family uses the ASIC Company Dataset published through data.gov.au, licensed CC-BY-3.0-AU, and stores company-level fields keyed by ACN. ABN appears when the source row publishes it, but the ACN remains the company-register key. The source should not be read as a private credit file or a judgment on company quality.

An attestation is a signed statement about an identified object. It can make later changes to that object detectable when the digest, signature, public key, and covered bytes are all available. Fonteum's attestation coverage is not universal: no provenance fact linked deterministically to a signature in the July 12 audit, and a signature does not establish that the underlying facts are correct or current.

Balance billing is the practice by which an out-of-network provider bills a patient for the difference between the provider's charge and the amount the patient's insurer pays — the 'balance'. The No Surprises Act prohibits balance billing in specified circumstances: emergency services, air ambulance transport, and non-emergency services at in-network facilities when the patient had no prior informed choice of provider. Medicare and Medicaid programs have long-standing limits on provider balance billing.

The Entity List is Supplement No. 4 to Part 744 of the Export Administration Regulations. BIS uses it to publish specific parties and high-risk addresses subject to additional export, reexport, and transfer controls. It is not the same as OFAC sanctions or SAM.gov exclusions: it is an export-control restriction that depends on the item, transaction, party, and license policy in the entry.

Bitemporal data modeling can record two time dimensions: valid time — when a fact applied — and transaction time — when it was recorded. Historical reconstruction works only when prior rows were actually retained. Fonteum's production history is source-specific, not a universal provider timeline.

A Commercial and Government Entity (CAGE) code is a five-character alphanumeric identifier assigned by the Defense Logistics Agency to organizations that do business with the U.S. federal government. It identifies a specific facility or location of a registered entity and is tied to that entity's Unique Entity Identifier in SAM.gov, where it appears on awards, payments, and exclusion records.

A Unique Entity ID is the 12-character GSA identifier for a registered entity in SAM.gov. A CAGE code is a five-character Commercial and Government Entity code maintained by the Defense Logistics Agency and tied to a location or facility. Procurement data often carries both. For entity resolution, UEI is usually the entity spine, while CAGE helps connect location-specific awards, exclusions, or supplier records to the correct entity.

Corporations Canada assigns corporation numbers to federal corporation records. The Canada Revenue Agency assigns business numbers for tax and program-account administration. A federal corporation record may carry a corporation number and a BN, but they answer different questions: the corporation number identifies the federal corporate record, while the BN identifies the business for CRA and other program-account purposes.

The CMS Certification Number (CCN) is a six-character identifier assigned by CMS to Medicare- and Medicaid-certified health care facilities, including hospitals, nursing homes, home health agencies, hospices, dialysis facilities, and ambulatory surgical centers. The CCN is the primary facility identifier in CMS administrative data and the linking key between datasets such as Care Compare, the Provider of Services (POS) file, and HCRIS cost reports. The first two characters generally encode state; the remaining characters identify the facility within that state and can encode facility type.

Chain ownership in the nursing home industry refers to an organizational structure in which a single corporate entity, common ownership group, or affiliated network controls two or more nursing home facilities. CMS defines chain organizations in the Provider of Services (POS) file and collects detailed ownership data through the SNF All Owners dataset derived from PECOS. Research has consistently found that chain-owned nursing homes — particularly those acquired by large private equity firms or publicly traded companies — show lower staffing levels and higher deficiency rates on average than independently operated facilities. CMS has expanded ownership transparency requirements, requiring nursing homes to disclose full ownership chains including management companies, investors, and affiliated entities.

A civil money penalty (CMP) is a monetary sanction imposed by CMS on Medicare- or Medicaid-certified health care facilities — most commonly nursing homes — for violations of federal Requirements of Participation. CMPs are authorized under Section 1819(h) of the Social Security Act for nursing homes and under parallel provisions for other facility types. CMS imposes per-day CMPs for each day a facility remains out of compliance, and per-instance CMPs for discrete violations. Penalty amounts are set by regulation and adjusted annually under the Federal Civil Penalties Inflation Adjustment Act. CMS publishes CMP amounts and dates on Care Compare and in the Civil Money Penalty Reinvestment Program database.

The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the U.S. Department of Health and Human Services that administers Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the Health Insurance Marketplace. CMS sets standards for health care quality, payment policy, and provider enrollment. The agency manages key public data systems including NPPES, PECOS, Care Compare, Open Payments, and the Quality Payment Program, and publishes provider, facility, and claims data used in health services research.

CMS Care Compare is a publicly accessible data resource that provides quality and performance information for Medicare-participating health care providers and facilities — including hospitals, nursing homes, home health agencies, hospices, dialysis facilities, ambulatory surgical centers, and clinicians. CMS launched Care Compare in 2020, consolidating previously separate comparison tools (Hospital Compare, Nursing Home Compare, Home Health Compare, and others) into a unified platform. Data includes star ratings, inspection results, staffing levels, and quality measures.

CMS Star Ratings are quality scores assigned to Medicare-participating providers, facilities, and health plans on a scale of 1 to 5 stars to help beneficiaries compare quality of care. Separate rating systems exist for nursing homes (Overall, Health Inspections, Staffing, and Quality Measures domains), home health agencies, dialysis facilities, hospices, and Medicare Advantage plans. Ratings are calculated from inspection results, staffing data, and quality measures reported to CMS. Methodologies are published annually in CMS technical documentation.

Companies House is the official UK company-register authority and the source behind Fonteum's `uk-companies-house` family. Fonteum uses the Free Company Data Product as the bulk spine, keyed by company number, and treats changing names, offices, SIC codes, filing dates, and status fields as dated register facts. The source is licensed under the Open Government Licence v3.0 and is distinct from a tax identifier, credit file, or private due-diligence report.

Company register bulk data is the practical substrate for a source-provenanced entity graph. Fonteum favors official bulk files, APIs, or approved feeds because they preserve source fields, update cadence, license, and limitations at scale. The platform does not treat a bulk company register as a quality badge: it is a dated public record about registration, identifiers, status, addresses, and related company-level facts.

The Consolidated Screening List (CSL) is a U.S. International Trade Administration search and data surface that combines multiple federal export-control and sanctions lists. It is meant to reduce one-list-at-a-time checks by letting users search Commerce, State, and Treasury records together. A CSL hit is a pointer to a source-list record, so the source agency and source list still matter.

Corporations Canada is the authority behind Fonteum's `canada-corporations` source family. Fonteum reads the Open Canada Federal Corporations CSV resources, licensed under the Open Government Licence - Canada, and stores corporation number and business number separately. That separation matters because the corporation number identifies the federal corporate record, while the BN is a tax and program-account identifier issued through CRA systems.

Current Procedural Terminology (CPT) codes are a proprietary set of medical codes maintained by the American Medical Association (AMA) that describe medical, surgical, and diagnostic procedures and services. CPT codes are required under HIPAA for reporting outpatient procedures on insurance claims. Each five-character code maps to a specific procedure. CMS assigns Relative Value Units (RVUs) to CPT codes in the Medicare Physician Fee Schedule, which determines physician payment rates.

A DEA number is a registration identifier issued by the U.S. Drug Enforcement Administration to practitioners, hospitals, pharmacies, researchers, manufacturers, distributors, and other registrants that handle controlled substances. The familiar manual check tests only whether the number's letters and digits fit the checksum pattern; it does not prove that a registration is active, unrestricted, or tied to the person or organization presenting it.

The Denied Persons List (DPL) is maintained by the U.S. Department of Commerce Bureau of Industry and Security. It names people and organizations whose export privileges have been denied under the Export Administration Regulations, including parts 764 and 766. Each denial order controls the scope and duration of the restrictions, so the listing and the order must be read together.

A Diagnosis Related Group (DRG) is a patient classification system that groups similar hospital inpatient cases into categories that are clinically coherent and resource-intensive. CMS uses Medicare Severity DRGs (MS-DRGs) to determine prospective payment amounts for hospital inpatient stays under Medicare Part A through the Inpatient Prospective Payment System (IPPS). Each DRG is assigned a relative weight representing average resource consumption. Hospitals receive a fixed payment per DRG regardless of actual costs.

In a third-party or KYC context, due diligence means collecting and assessing enough information to understand the counterparty, the purpose of the relationship, ownership and control, sanctions or exclusion exposure, and changes over time. It is an evidence workflow, not a one-time search. Strong programs preserve sources, dates, limitations, and the reasoning used to clear or escalate a record.

The D-U-N-S Number is Dun & Bradstreet's proprietary business identifier. It historically appeared in many vendor, grant, and federal-award workflows, but the U.S. government moved SAM.gov and related systems to the government-owned Unique Entity ID on April 4, 2022. In a public-record entity graph, DUNS should be treated carefully: it can explain older records, but it is not the current public spine for SAM.gov identity.

The DUNS number was a proprietary Dun & Bradstreet identifier that federal systems historically used to identify organizations. The Unique Entity Identifier (UEI) is the government-generated replacement issued in SAM.gov. GSA switched SAM.gov and other systems to UEI on April 4, 2022, so current federal registrations, awards, and exclusions should be read against UEI first, with DUNS retained only for older records and crosswalks.

The EDI 837 is a HIPAA-standard electronic data interchange format for submitting health care claims. Three transaction sets exist: 837P (Professional, based on CMS-1500), 837I (Institutional, based on UB-04), and 837D (Dental). Maintained by ASC X12 and implemented under HIPAA Administrative Simplification, the 837 replaced paper claims for covered transactions. Clearinghouses translate provider billing software output into X12 837 format for payer submission. CMS requires the 837 for all Medicare claims.

An Electronic Health Record (EHR) is a digital version of a patient's medical chart that is real-time, patient-centered, and accessible to authorized users across health care settings. EHRs contain medical history, diagnoses, medications, treatment plans, immunization records, allergies, radiology images, and laboratory results. Under the HITECH Act and ONC's Health IT Certification program, EHR adoption expanded substantially after 2009. EHRs differ from Electronic Medical Records (EMRs) in that EHRs are designed for cross-organizational information sharing.

Entity resolution is the process of determining when records across different datasets refer to the same real-world entity — a single provider, facility, or organization. In health care data, the same physician can appear under different name spellings, addresses, and identifiers across NPPES, PECOS, Open Payments, and exclusion lists. Entity resolution links those records to one resolved identity, usually anchored on a stable key such as the NPI for individuals or the CMS Certification Number for facilities, so a fact in one source can be joined to a fact in another.

An Electronic Remittance Advice (ERA) is a HIPAA-standard electronic document (ASC X12 835 transaction) that a health care payer sends to a provider explaining payment decisions on submitted claims. ERAs specify which services were paid, denied, or adjusted and include standardized reason codes. Under HIPAA, payers must transmit ERAs to providers who request them electronically. ERA data is the primary mechanism for providers to reconcile Medicare and commercial insurance payments in accounts receivable management systems.

End-Stage Renal Disease (ESRD) is permanent, complete kidney failure that requires dialysis or a kidney transplant to maintain life. ESRD is the only condition — regardless of age — that qualifies individuals for Medicare solely on the basis of diagnosis. Medicare ESRD coverage begins the fourth month of dialysis treatment or upon kidney transplant. CMS tracks dialysis facility quality through the ESRD Quality Incentive Program (QIP) and publishes facility performance data on Care Compare. In 2024, approximately 808,000 patients receive ESRD treatment in the United States.

Exclusion screening is the practice of checking the health care providers, vendors, and contractors an organization bills federal programs for against federal and state exclusion lists before submitting claims and on an ongoing basis. The OIG List of Excluded Individuals/Entities (LEIE) is the primary federal source; the GSA SAM.gov exclusions file and individual state Medicaid exclusion lists extend coverage. Excluded parties may not be paid, directly or indirectly, by Medicare, Medicaid, or any other federal health care program, so most compliance programs screen monthly to match CMS guidance. It is a billing and program-integrity control, not a consumer report, and must not be used for employment, credit, insurance, housing, or professional-licensing eligibility decisions about an individual.

An Explanation of Benefits (EOB) is a document sent by a health insurer to a covered member and provider after a claim is processed, explaining what services were billed, what the plan paid, what was denied, and what the member may owe. EOBs are not bills; they are informational summaries. Under the CMS Interoperability and Patient Access Final Rule, Medicare Advantage and Medicaid plans must make EOB and claims data available to beneficiaries through FHIR-based Patient Access APIs, enabling members to retrieve their claims history electronically.

An F-tag (Federal tag) is an alphanumeric code used by CMS to identify specific regulatory requirements under 42 CFR Part 483 that nursing homes and long-term care facilities must meet to participate in Medicare and Medicaid. When a state surveyor finds a facility out of compliance, the finding is cited under the specific F-tag violated. After CMS's 2017 regulatory revision, F-tags run from F550 to F947, reorganized to align with resident rights, facility practices, and quality-of-care standards. Tags are grouped into categories: resident rights, facility operations, quality of care, and others. Deficiencies under tags associated with actual harm or immediate jeopardy can trigger civil money penalties or denial of payment for new admissions.

The Federal Awardee Performance and Integrity Information System (FAPIIS) is a federal database that records contractor integrity and performance information used in responsibility determinations. It captures terminations for cause or default, defective-pricing findings, non-responsibility determinations, and certain proceedings, giving a contracting officer a record of an entity's past conduct before a new award is made.

An FCC identifier is used on equipment that has a grant of certification under FCC equipment authorization rules. The identifier consists of the FCC-assigned grantee code and the grantee's equipment product code. Researchers use it to look up grants, filings, exhibits, and technical details for a device model, not to identify an end user or prove that every marketed unit remains unchanged.

Federal award is the umbrella concept used in public spending data. USASpending.gov publishes both assistance and procurement awards, with transactions and summary fields reported by agencies under federal spending-transparency law. Fonteum uses federal award data for procurement evidence surfaces, but it keeps award facts separate from SAM.gov registration, SAM.gov exclusions, FAPIIS integrity records, and SBA set-aside certification facts.

Federal set-asides are governed by small-business contracting rules, including FAR Part 19 and SBA program requirements. Fonteum's procurement layer reads SBA certification facts from the `sba-certifications` source family and award context from USASpending.gov, then keeps those facts separate from SAM.gov exclusions and entity-registration status. A set-aside fact can describe program eligibility or an award context, but it does not prove present performance quality or future eligibility.

An Employer Identification Number is a federal tax identification number issued by the Internal Revenue Service. FEIN is a common shorthand for Federal Employer Identification Number; in most business-data contexts it refers to the same IRS-issued identifier. EINs can be important in private records, tax administration, payroll, banking, and filings, but they are not the same as public identifiers such as UEI, CAGE, NPI, CCN, LEI, or company-register numbers.

Fast Healthcare Interoperability Resources (FHIR) is a standard for health care data exchange developed by HL7 International. FHIR defines modular data elements — resources such as Patient, Practitioner, Organization, and Observation — exchangeable via REST APIs, JSON, and XML using standard web technologies. The ONC 21st Century Cures Act Final Rule mandated FHIR-based APIs for certified EHRs starting in 2022. FHIR R4 is the current base standard for U.S. health care interoperability.

Operating authority is FMCSA permission for regulated interstate for-hire transportation, brokerage, or freight-forwarding activity. It is commonly represented by MC, FF, or MX docket numbers and is separate from the USDOT number used for carrier safety registration. A company can need both: USDOT for safety identity and operating authority for the specific service it offers in interstate commerce.

IRS Form 990 is filed by many tax-exempt organizations, including charities, foundations, and tax-exempt hospitals. The core form reports organizational identity, program service accomplishments, revenue, expenses, officers, compensation, and governance practices. Schedules add detail for specific categories, such as Schedule H for nonprofit hospitals' community-benefit reporting. Analysts use it as one public record in a broader diligence file.

FPDS matters because older procurement references, contract-action records, and agency workflows still use the name. Fonteum explains FPDS as a procurement data-system concept and uses the current USASpending.gov award source families for public award records. For users, the practical distinction is simple: FPDS is a source-system lineage term, while USASpending.gov is the public portal and API used for award transparency.

A Federally Qualified Health Center (FQHC) is a community-based health care provider that receives funding from the HRSA Health Center Program to provide primary care services to medically underserved areas and populations. FQHCs must serve all patients regardless of ability to pay and offer a sliding-fee discount schedule. Under Medicare and Medicaid, FQHCs receive an enhanced prospective payment rate. As of 2024, approximately 1,400 HRSA-funded health center grantees operate over 15,000 service delivery sites serving nearly 31 million patients annually.

The French RNE is the national register Fonteum maps through the `france-rne-inpi` source family. The adapter reads company-register data from INPI's RNE API/SFTP surface, keys legal-entity facts on SIREN, and excludes natural-person and INSEE non-diffusible records. RNE data is useful for legal-entity identity and establishment context, but it is not the same as a sanctions record, procurement eligibility record, or credit opinion.

The FCC Registration Number is the Commission's registrant identifier for entities and individuals that interact with FCC systems. Federal rules require an FRN for many filings, feeable transactions, license applications, and auction activities. In data work, the FRN identifies the party doing business with the FCC, while call signs, application file numbers, facility IDs, and FCC IDs identify different records.

The Healthcare Common Procedure Coding System (HCPCS) is a standardized coding system used to identify health care services, supplies, products, and equipment for billing in Medicare, Medicaid, and other programs. HCPCS Level I codes are AMA CPT codes; HCPCS Level II codes are alphanumeric codes maintained by CMS covering durable medical equipment, prosthetics, orthotics, supplies, drugs, and other items not covered by CPT. CMS publishes the HCPCS Level II code set annually.

The Healthcare Cost Report Information System (HCRIS) is a CMS database of annual cost reports submitted by Medicare-participating health care facilities — including hospitals, nursing homes, home health agencies, and others. Cost reports capture detailed financial and operational data including total charges, total costs, number of beds, staffing hours, and Medicare utilization. HCRIS data is publicly available and forms the basis for research on hospital financial health, profit margins, and cost structure. CMS releases quarterly HCRIS file updates; historical data extends to the 1990s.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that established national standards for the privacy and security of individually identifiable health information and for electronic health care transactions. HIPAA's Administrative Simplification provisions mandate standard transaction formats (including NPI), require privacy protections for Protected Health Information (PHI), and establish security safeguards for electronic PHI. HHS's Office for Civil Rights enforces the HIPAA Privacy and Security Rules.

Health Level Seven International (HL7) is an accredited standards development organization that creates frameworks and standards for health information technology. HL7 develops messaging standards (HL7 v2.x), clinical document standards (C-CDA / CDA), and the modern FHIR interoperability standard. The name 'Level Seven' refers to the seventh layer of the ISO OSI model — the application layer. HL7 v2 messages remain the most widely deployed health care data exchange format in hospital information systems globally.

A Health Professional Shortage Area (HPSA) is a geographic area, population group, or facility designated by HRSA as having a shortage of primary medical care, dental, or mental health providers. HPSA designations trigger eligibility for National Health Service Corps scholarships and loan repayment and enhanced Medicare payment rates (+10% for primary care in geographic HPSAs). HRSA uses a scoring system based on provider-to-population ratios, distance to nearest care source, and percentage of population below 100% of the federal poverty level.

The Health Resources and Services Administration (HRSA) is a federal agency within HHS that improves health care access to people who are geographically isolated or economically or medically vulnerable. HRSA programs include the Health Center Program (FQHCs), the National Health Service Corps, and the Ryan White HIV/AIDS Program. HRSA also designates Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs) and publishes the Uniform Data System (UDS) — an annual dataset of FQHC performance and patient demographics.

The HRSA Uniform Data System (UDS) is an annual reporting system through which federally funded health centers — Federally Qualified Health Centers (FQHCs), FQHC Look-Alikes, and other Health Center Program grantees — submit standardized performance and patient demographic data to the Health Resources and Services Administration. UDS data covers patient characteristics, clinical quality measures, staffing, financial information, and services delivered at each grantee site. HRSA uses UDS data to monitor grantee performance against program requirements and publishes aggregate and site-level data publicly through the UDS Mapper and flat-file downloads. The UDS dataset covers approximately 1,400 grantees operating over 15,000 service delivery sites serving approximately 31 million patients annually.

The HUBZone program is an SBA contracting-assistance program intended to route federal contracting dollars to small businesses in designated underutilized areas. Certification depends on size, ownership, principal office location, and employee residency rules. HUBZone status changes as addresses, employees, and mapped zones change, so contracting teams treat it as a dated eligibility fact tied to a specific entity.

ICD-10 is a medical coding system used to classify diagnoses, symptoms, and medical procedures. The World Health Organization maintains ICD-10 globally; the United States uses two adaptations — ICD-10-CM (Clinical Modification) for diagnoses, maintained by the CDC, and ICD-10-PCS (Procedure Coding System) for inpatient procedures, maintained by CMS. ICD-10 replaced ICD-9 for U.S. HIPAA transactions in October 2015. ICD-10-CM contains over 70,000 diagnosis codes used on all HIPAA-covered claims.

The Legal Entity Identifier is a 20-character alphanumeric code based on ISO 17442 and used to identify legal entities. The Global Legal Entity Identifier Foundation maintains the Global LEI System and publishes LEI reference data, including legal name, registered address, headquarters address, entity status, registration authority, and renewal status. In entity-resolution work, LEI is useful because it is cross-jurisdictional and tied to structured reference data.

The List of Excluded Individuals/Entities (LEIE) is a database maintained by the HHS Office of Inspector General (OIG) of individuals and entities barred from participation in federal health care programs. OIG publishes a monthly bulk CSV. Fonteum's loaded release was dated May 8, 2026 when checked July 12, so consequential status must be confirmed at OIG.

A Machine-Readable File (MRF) is a structured data file published by hospitals and health insurers under federal price transparency regulations. Under the CMS Hospital Price Transparency Rule (effective January 2021), hospitals must publish an MRF containing standard charges for all items and services. Under the Transparency in Coverage Rule (effective July 2022), group health plans must publish MRFs containing in-network negotiated rates and out-of-network allowed amounts. MRFs are typically published in JSON or CSV format and must be publicly accessible without authentication.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a federal law that repealed the Sustainable Growth Rate (SGR) formula for Medicare physician payment and established the Quality Payment Program. MACRA created MIPS and Advanced APMs as the two pathways for clinician participation, shifted Medicare payment toward value-based models, and mandated interoperability requirements for EHRs. MACRA was signed into law on April 16, 2015. CMS began collecting MIPS performance data under MACRA in January 2017.

Medicaid is a joint federal-state health insurance program that provides coverage to low-income individuals and families, including children, pregnant women, elderly adults, and people with disabilities. Authorized by Title XIX of the Social Security Act, Medicaid is administered by states within federal guidelines. CMS oversees federal Medicaid policy and matching payments. In 2024, Medicaid and CHIP combined covered approximately 90 million individuals, making it the largest source of health insurance coverage in the United States.

Medicare is the federal health insurance program administered by CMS for people age 65 or older, certain younger individuals with disabilities, and people with End-Stage Renal Disease. Established by Title XVIII of the Social Security Act in 1965, Medicare covers inpatient hospital care (Part A), outpatient and physician services (Part B), prescription drugs (Part D), and managed care alternatives (Part C / Medicare Advantage). In 2024, Medicare covered approximately 67 million beneficiaries.

Medicare Advantage (Part C) is an alternative to traditional Medicare in which private health plans — approved and paid by CMS — deliver all Medicare-covered benefits plus optional supplemental benefits such as vision, dental, and hearing. CMS reimburses Medicare Advantage plans through risk-adjusted capitation payments. CMS publishes plan performance data including star ratings, enrollment figures, and quality metrics. In 2024, approximately 33 million Medicare beneficiaries — more than 50% of total Medicare enrollment — are enrolled in Medicare Advantage plans.

A Medicare Cost Report is an annual financial and utilization report that Medicare-participating health care facilities — including hospitals, skilled nursing facilities, home health agencies, hospices, and renal dialysis facilities — must file with CMS each fiscal year. Filed on CMS Form 2552-10 (hospitals) or facility-type-specific forms, cost reports capture total charges, operating costs by service line, Medicare utilization statistics, staffing hours, and cost-to-charge ratios. CMS compiles all cost reports in the Healthcare Cost Report Information System (HCRIS) and releases them quarterly as public-use files. Medicare Cost Reports are a primary source for hospital financial transparency research, including analysis of operating margins, uncompensated care, and Medicare payment-to-cost ratios.

The Merit-Based Incentive Payment System (MIPS) is a CMS value-based payment program under the Quality Payment Program that adjusts Medicare clinician reimbursement based on performance across four categories: Quality, Promoting Interoperability, Improvement Activities, and Cost. MIPS applies to eligible clinicians — physicians, nurse practitioners, physician assistants, and others — who meet Medicare volume thresholds. Scores range from 0 to 100; high performers receive positive payment adjustments and low performers receive negative adjustments. MIPS was established under MACRA in 2015.

The North American Industry Classification System is the standard used by federal statistical agencies to classify establishments for collecting, analyzing, and publishing business-economy statistics. NAICS codes range from broad sectors to six-digit industries. In federal procurement, NAICS appears on registrations and awards so spending can be grouped by industry. The code describes economic activity; it does not state capability, quality, or compliance status by itself.

The No Surprises Act (Division BB of the Consolidated Appropriations Act, 2021) is a federal law effective January 1, 2022, that protects patients from unexpected out-of-network bills in specified circumstances. The law limits patient cost-sharing to in-network rates for emergency services, air ambulance services, and non-emergency care at in-network facilities when the patient had no informed choice of provider. It also established an independent dispute resolution (IDR) process for payment disputes between insurers and providers.

The National Provider Identifier (NPI) is a unique, 10-digit numeric identifier assigned to health care providers in the United States under HIPAA Administrative Simplification. Administered by CMS through NPPES, an NPI is permanent and does not change when a provider changes their name, address, or taxonomy. All HIPAA-covered health care providers must obtain an NPI for use in administrative and financial transactions, including claims, eligibility inquiries, and remittance advice.

The National Provider Identifier is a CMS-administered identifier for HIPAA-covered providers and organizations. A DEA registration number is issued under the Controlled Substances Act to practitioners, facilities, pharmacies, researchers, manufacturers, and distributors that handle controlled substances. The NPI is a provider identity key; the DEA number is a controlled-substance registration key. They answer different credentialing questions and should not be substituted for each other.

The National Plan and Provider Enumeration System (NPPES) is the CMS database that assigns and maintains National Provider Identifiers. Eligible healthcare providers apply through NPPES, which collects administrative fields such as submitted names, practice locations, and taxonomy codes. NPPES data is publicly downloadable as a bulk file and accessible through the NPI Registry API. The system enumerates eligible individuals (Type 1) and organizations (Type 2); enumeration does not establish licensure or credentialing.

The National Uniform Claim Committee (NUCC) is a voluntary organization led by the American Medical Association that maintains the standard professional claim form (CMS-1500) and the Healthcare Provider Taxonomy code set used in HIPAA administrative transactions. NUCC taxonomy codes identify a provider's type, classification, and specialization for purposes of NPI enumeration and claim processing. NUCC publishes taxonomy code updates annually. The complete NUCC taxonomy code set is publicly available and is the authoritative source for all taxonomy codes stored in NPPES.

The NZ Companies Register sits beside the NZBN Register and provides company-level register data for New Zealand entities. Fonteum's `nz-companies-register` source family is defined as an operator-script ingest from approved bulk files and stores company-level fields only. Director, shareholder, and other person-level CSVs are excluded from the public table, preserving the entity-level scope required by Fonteum's global-register doctrine.

The New Zealand Business Number is the identifier used by the NZBN Register to connect a business or organization with its published primary business data. The identifier is available across business structures, not only companies. In company-register data, NZBN can be read with the Companies Register number and entity status so New Zealand records can be matched without relying only on names.

The Office of Foreign Assets Control (OFAC) is the Treasury bureau responsible for administering U.S. economic and trade sanctions based on national-security and foreign-policy authorities. OFAC publishes sanctions lists, including the Specially Designated Nationals and Blocked Persons List, and provides search tools, data files, regulations, licenses, and public guidance for sanctions compliance.

The Office of Financial Sanctions Implementation is the HM Treasury unit responsible for helping UK financial sanctions be understood, implemented, and enforced. OFSI publishes guidance, handles financial-sanctions licensing, receives breach reports, and imposes monetary penalties. For current designation data, use the UK Sanctions List: the old OFSI Consolidated List of Asset Freeze Targets closed on January 28, 2026 and is no longer updated.

An OIG exclusion is a formal administrative sanction imposed by the HHS Office of Inspector General that prohibits an individual or entity from participating in Medicare, Medicaid, and all other federally funded health care programs. Mandatory exclusions are required by statute — for example, felony convictions for health care fraud. Permissive exclusions are at the OIG's discretion. Excluded parties cannot receive federal program payment directly or through an employer. Exclusion records are published in the LEIE.

CMS Open Payments is a national disclosure program established by the Physician Payments Sunshine Act that collects and publishes information about financial relationships between drug and device manufacturers and applicable physicians, teaching hospitals, and other health care providers. Manufacturers and group purchasing organizations (GPOs) report payments and transfers of value — including consulting fees, research grants, meals, travel, and royalties — to CMS annually. Open Payments data is publicly searchable at openpaymentsdata.cms.gov.

The Online Survey, Certification, and Reporting System (OSCAR) was the CMS database through which state survey agencies recorded inspection and certification data for Medicare- and Medicaid-participating health care facilities, including nursing homes, hospitals, home health agencies, and intermediate care facilities. State surveyors submitted deficiency citations, waivers, complaints, and remedy actions into OSCAR following on-site visits. CMS used OSCAR data to populate early versions of Nursing Home Compare. The system was succeeded by CASPER (Certification and Survey Provider Enhanced Reports), which consolidates the OSCAR-originated survey records and serves as the underlying data source for the Health Inspections domain published on Care Compare.

The Payroll-Based Journal (PBJ) is a CMS system requiring nursing homes and long-term care facilities to submit direct care staffing data electronically on a quarterly basis. Mandated under the Affordable Care Act and the SNF Staffing Final Rule, PBJ data includes actual hours worked by nursing staff by day, job type, and hire type (employee vs. contract staff). CMS uses PBJ data to calculate the Staffing Rating component of nursing home star ratings on Care Compare. PBJ data is publicly available and widely used in nursing home staffing research.

The Provider Enrollment, Chain, and Ownership System (PECOS) is the CMS enrollment database for Medicare providers and suppliers. PECOS stores enrollment records for practitioners, group practices, and suppliers who have applied to participate in Medicare. The system records enrollment status, effective dates, practice locations, and reassignment of billing rights. The PECOS Public Extract (PPEF) is a periodically released public file enabling external verification of Medicare enrollment status by NPI.

Protected Health Information (PHI) is any individually identifiable health information held or transmitted by a HIPAA covered entity or business associate, in any form or medium. PHI includes diagnoses, treatment records, payment information, and any data that could identify the individual — name, address, dates of service, Social Security number, and 16 other identifiers enumerated in the HIPAA Privacy Rule. De-identified information that cannot reasonably be used to identify an individual is not PHI and falls outside HIPAA's Privacy Rule protections.

Ponzi schemes are named after Charles Ponzi and appear in many investment contexts, from private offerings to digital-asset promotions. The defining feature is not merely high risk; it is the use of new investor money to satisfy older investor claims while presenting the payments as investment returns. Public enforcement records may describe alleged or adjudicated schemes, but each record must be read by source and date.

Prime awards are central to federal procurement transparency because they identify the direct relationship between a federal awarding agency and the recipient recorded on the award. Fonteum's procurement surfaces use prime-award records from USASpending.gov so contractor and agency pages can state dated award facts without inferring subcontract relationships that are outside the source row. Prime-award evidence is read with UEI, agency, amount, date, NAICS, and set-aside fields where present.

Prior authorization is a requirement by a health insurer that a provider obtain approval before delivering certain services, procedures, or medications for them to qualify for reimbursement. Used to manage utilization and cost, prior authorization has been associated with treatment delays and administrative burden. The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) requires payers to implement FHIR-based APIs for electronic prior authorization beginning in 2027 for Medicare Advantage, Medicaid, and CHIP plans.

Private equity (PE) ownership in health care refers to the acquisition and control of health care facilities and provider organizations — including nursing homes, physician practices, hospitals, and behavioral health providers — by private equity funds. PE firms typically acquire health care entities through leveraged buyouts, apply financial and operational restructuring, and exit within 3–7 years through resale or initial public offering. Multiple peer-reviewed studies have associated PE ownership of nursing homes with reduced staffing hours, increased deficiency citations, and higher short-term mortality among residents. CMS introduced mandatory private equity ownership disclosure requirements for nursing homes in 2023, and this data is published through the SNF All Owners dataset and Care Compare.

Data provenance is the documented record of where a piece of data came from, how it was obtained, and how it has changed over time. For a single field on a provider record — a name, an address, an exclusion date — provenance can identify which source published it, when that source was captured, and what transformation produced the displayed value. When a response supplies that lineage, a downstream user can trace the fact to a named government file and reporting period.

Provider credentialing is the process by which health plans, hospitals, and health systems confirm a clinician's qualifications — license, education, training, board certification, and history — before granting privileges or network participation. Credentialing relies on primary-source data, and re-credentialing repeats it on a set cycle. Exclusion and sanction checks against federal lists are a standard part of the process.

Provider enrollment is the process by which health care providers and suppliers apply for and maintain participation in Medicare, Medicaid, or other federal health care programs. CMS manages Medicare enrollment through PECOS. Providers submit CMS-855 forms (or online equivalents) to apply, revalidate, or update enrollment records. Enrolled providers receive a PTAN from their Medicare Administrative Contractor. CMS may revoke, deny, or bar enrollment for fraud, OIG exclusion, or failure to meet program standards.

A Provider Transaction Access Number (PTAN) is an identifier assigned by a Medicare Administrative Contractor (MAC) to individual providers or supplier organizations upon Medicare enrollment. Unlike the national NPI, a PTAN is jurisdiction-specific — issued by the MAC serving a provider's geographic area. PTANs appear on Medicare remittance advice and are required for electronic eligibility transactions. A single NPI may be associated with multiple PTANs across enrollment records.

The Quality Payment Program (QPP) is a CMS framework established by MACRA that replaced the Sustainable Growth Rate (SGR) formula for Medicare clinician reimbursement. QPP offers two participation pathways: MIPS (Merit-Based Incentive Payment System) and Advanced Alternative Payment Models (APMs). Eligible clinicians choose a pathway based on practice size, specialty, and patient volume. QPP ties Medicare payment rates to quality and value metrics. CMS publishes individual and group QPP performance scores as public data accessible through qpp.cms.gov.

A Real Estate Investment Trust (REIT) in the healthcare context is a publicly traded or private investment vehicle that owns the real estate — buildings, land, and facility infrastructure — used by nursing homes, hospitals, senior housing, and other health care providers. Healthcare REITs typically do not operate care facilities directly; instead they lease properties to operators under long-term triple-net leases in which the tenant bears maintenance, insurance, and property tax costs. Federal law (Internal Revenue Code § 856) governs REIT structure and requires distributing at least 90% of taxable income to shareholders as dividends. CMS began collecting and publishing REIT ownership information in nursing home ownership disclosure data, creating transparency into the separation between property ownership and facility operation.

A SAM.gov exclusion is a government-wide bar that prevents an individual or entity from receiving federal contracts, grants, or other assistance. The U.S. General Services Administration publishes exclusions in the System for Award Management (SAM.gov), consolidating suspensions and debarments from agencies across the government. Each record names the excluded party, the excluding agency, the exclusion type, and its dates.

SAM.gov registration is the U.S. government's registration workflow for entities that want to do business with the federal government as prime awardees or apply directly for federal assistance. Registration creates or updates the entity record, assigns the UEI when needed, and carries fields such as legal name, physical address, registration status, CAGE code, and representations. A UEI-only request is narrower: it creates an identifier without an active award-registration record.

DSBS matters because it is a primary public context for small-business contractor identity and SBA program facts. Fonteum's `sba-certifications` source family is limited to government-origin certification facts from SBA sources and excludes D&B firmographic fields. The result is a source-dated eligibility layer, not a general endorsement of the firm or its services. Program-specific certification should be read with current SBA rules and SAM.gov status.

A Specially Designated National (SDN) is a party listed on OFAC's Specially Designated Nationals and Blocked Persons List. The list can include individuals, companies, groups, vessels, and aircraft. When a party is listed, property and interests in property subject to U.S. jurisdiction are blocked, and U.S. persons generally may not deal with that party unless a license or other authorization applies.

The Standard Industrial Classification system grouped establishments by primary business activity before NAICS became the federal statistical standard. SIC remains useful because many legacy datasets, older filings, and industry tools still carry SIC values. In source-provenance work, a SIC code should be stored as the source reported it, then crosswalked to NAICS only when the crosswalk and its limitations are explicit.

The SIREN number is the legal-unit identifier in France's Sirene system, maintained by INSEE. It identifies the legal unit rather than a specific establishment or location. In company-register and entity-resolution work, SIREN is the legal-entity key for French organizations, while SIRET is the establishment-level key used when the question is about a physical site, branch, or operating location.

INSEE's Sirene register assigns SIREN numbers to legal units and SIRET numbers to establishments. The SIRET embeds the SIREN of the legal unit and adds the NIC, an internal classification number for the establishment. For cross-border entity resolution, SIREN identifies the legal entity, while SIRET identifies the operating site or location-level establishment.

The SIRET number identifies an establishment in France's Sirene register. It is built from the legal unit's SIREN plus a five-digit NIC code assigned to the establishment. That structure makes SIRET useful for location-level questions, such as matching a branch, site, or office. It should not replace SIREN when the fact belongs to the legal unit as a whole.

A Skilled Nursing Facility (SNF) is a Medicare-certified inpatient facility that provides skilled nursing care, physical therapy, occupational therapy, and speech-language pathology services. Medicare Part A covers SNF stays after a qualifying three-day inpatient hospital stay. CMS reimburses SNFs under the Patient-Driven Payment Model (PDPM). SNF quality data — including staffing levels, inspection results, and quality measures — is published on CMS Care Compare. In 2024, over 15,000 SNFs are certified to participate in Medicare.

The Special Focus Facility (SFF) program is a CMS initiative that identifies nursing homes with serious and persistent quality problems — typically those with the worst health inspection records over three years — for heightened oversight and more frequent surveys. SFF-designated facilities receive standard surveys approximately every six months rather than annually. CMS calculates SFF scores using a weighted formula that gives greater weight to more recent and more severe deficiency citations. Facilities that do not demonstrate sustained improvement may be terminated from Medicare and Medicaid participation. CMS publishes the active SFF list quarterly; SFF status is also reflected in Care Compare records.

The Physician Payments Sunshine Act (Section 6002 of the Affordable Care Act) requires applicable manufacturers and group purchasing organizations to report to CMS all payments or transfers of value made to physicians and teaching hospitals. CMS collects and publicly discloses this data through the Open Payments program. The law was enacted to increase transparency about financial relationships between health care industry and practitioners. Reportable transfers include research payments, honoraria, entertainment, consulting fees, gifts, and speaker program payments.

A survey deficiency is a finding recorded by a state survey agency during an on-site inspection of a Medicare- or Medicaid-certified health care facility indicating that the facility failed to meet a specific federal Condition of Participation or Requirement of Participation. For nursing homes, deficiencies are catalogued using F-tags — federal regulatory tags identifying the specific regulatory requirement violated. Each deficiency is assigned a scope (isolated, pattern, or widespread) and severity (potential for minimal harm, minimal harm, actual harm, or immediate jeopardy), which together determine the enforcement remedies CMS may apply. Deficiency data is published on CMS Care Compare and drives the Health Inspections component of nursing home star ratings.

Suspension and debarment are the two federal actions that exclude a party from new government awards. A suspension is a temporary bar, generally pending an investigation or legal proceeding; a debarment is a fixed-term exclusion, typically not exceeding three years, imposed for cause under the Federal Acquisition Regulation. Both are published government-wide in SAM.gov and tagged by exclusion type.

A healthcare provider taxonomy code is a 10-character alphanumeric code that classifies a provider's type, classification, and specialization. Maintained by the National Uniform Claim Committee (NUCC), taxonomy codes are used in HIPAA transactions and stored in NPPES alongside each NPI record. A provider may have multiple taxonomy codes, with one designated as primary. The code structure groups providers hierarchically: individuals, non-individual practitioners, and suppliers, each subdivided by specialty.

A Type 1 NPI is assigned to an eligible individual healthcare provider. An enumerated individual is eligible for one Type 1 NPI regardless of practice locations or organizational affiliations. The NPI is an administrative identifier and does not prove that the individual holds a current license or credential.

A Type 2 NPI is a National Provider Identifier assigned to organizations — health care entities that provide health care services or supplies and have a workforce that submits claims under the organization's name. Hospitals, group practices, clinics, laboratories, and home health agencies are examples. A single organization may have multiple Type 2 NPIs for distinct subparts that file separately with Medicare. Type 2 NPIs are managed through NPPES and included in public bulk data downloads.

The Unique Entity Identifier (UEI) is a 12-character alphanumeric identifier assigned by the U.S. General Services Administration through SAM.gov to every organization registered to do business with, or be tracked by, the federal government. The UEI replaced the DUNS number in April 2022 as the official entity identifier across federal award systems. In health care exclusion data, the UEI identifies organizational entities on the SAM.gov exclusions file, complementing the NPI, which enumerates individual and organizational providers, and the CMS Certification Number, which identifies certified facilities.

A UK company number, often called a company registration number, is assigned by Companies House and used to retrieve a company profile in the public register. It stays with the registered body even when names or addresses change. In data work, the company number is the source key for Companies House records, while names, registered offices, status, and filings are attributes that can change over time.

The Unique Physician Identification Number (UPIN) was a six-character alphanumeric Medicare identifier assigned to physicians beginning in 1984. UPINs were required on Medicare claims for referring and ordering physicians. CMS replaced UPINs with NPIs for all HIPAA-covered transactions on May 23, 2007. Although no longer used in active Medicare billing, UPINs appear in legacy Medicare claims data and historical research datasets, particularly for studies using data predating the NPI transition.

USASpending.gov is the source behind Fonteum's `usaspending-awards` and `usaspending-award-transactions` families. Fonteum uses the public API and monthly archive data to connect federal award facts to the UEI spine, procurement agency profiles, NAICS pages, contractor profiles, and top-contractor snapshots. The data describes reported federal awards and obligations; it is not a compliance verdict about a recipient.

A USDOT number is assigned through the Federal Motor Carrier Safety Administration registration system to companies that operate covered commercial motor vehicles. It is the carrier identity key used in federal safety monitoring, including audits, compliance reviews, inspections, crash investigations, and enforcement records. It should not be confused with an MC, FF, or MX docket number, which relates to FMCSA operating authority for certain for-hire transportation services.

Value-based care is a health care delivery model in which providers are reimbursed based on patient health outcomes and care quality rather than the volume of services rendered. Contrasted with fee-for-service payment, value-based arrangements include quality metrics, total cost-of-care targets, and shared savings or shared risk provisions. CMS administers value-based care programs through the Innovation Center (CMMI), including Accountable Care Organizations, bundled payment models, and Primary Care First. The model aims to reduce unnecessary utilization while improving clinical outcomes.

The Women-Owned Small Business Federal Contract program limits competition for certain federal contracts to participating woman-owned small businesses, and in some industries to economically disadvantaged woman-owned small businesses. SBA rules focus on ownership, control, citizenship, size status, and industry eligibility. The certification is a procurement eligibility status, not a general quality label for a company or its services.