{ "slug": "deactivated-still-billing", "title": "NPPES-deactivated NPIs still billing public claims data (all states)", "hypotheses": [ "H31" ], "status": "published", "release_date": "2026-05-17", "generated_at": "2026-05-17T15:37:01+00:00", "methodology_version": "0.6.1-draft", "commit_sha": "334099e", "headline": "195 of 78,995 NPPES-deactivated NPIs (across all states, per NDH practice-state retention; NPPES nulls practice state on deactivation) billed at least one public claims source STRICTLY AFTER their NPPES deactivation date. Post-deactivation totals: Medicaid $13,709,307, Medicare Part B $2,841,502 (CY 2023), Medicare Part D $9,044,086 drug cost (CY 2023). 62 of 195 matched NPIs appear in MULTIPLE post-deactivation billing sources, which is a stronger signal than any single source. Match rule: claim month/year > NPPES deactivation month/year. Each match is either a data-quality problem (NPI reused or misattributed) or evidence of work being done under a closed identifier \u2014 both are state PI triage flags.", "numerator": 195, "denominator": 78995, "denominator_note": "Cohort = 78,995 NPIs that are NPPES-deactivated (npi_deactivation_date IS NOT NULL, npi_reactivation_date IS NULL) AND appear in NDH practitioner with a populated _state. NPPES nulls practice address fields on deactivation, so state attribution comes from the NDH side (the H10 \"NPPES-deactivated but still listed in NDH\" signal extended to its claims-side consequence). Per-state CSVs at /api/v1/states//h31-deactivated-paid.csv.", "data_source_release": "HHS 2026-02-09 + Medicare CY 2023 + NPPES (BigQuery public dataset)", "chart": { "type": "bar", "unit": "count", "data": [ { "label": "NPPES-deactivated NPIs still billing", "value": 195 }, { "label": "Multi-source post-deactivation matches", "value": 62 } ] }, "per_state": [ { "state": "CA", "matches": 25, "multi_source": 7, "medicaid_paid_post_deactivation": 1684868.46, "partb_paid_cy2023": 172396.58, "partd_drug_cost_cy2023": 208037.32, "cohort_size": 10626 }, { "state": "NY", "matches": 21, "multi_source": 8, "medicaid_paid_post_deactivation": 907980.33, "partb_paid_cy2023": 352440.42, "partd_drug_cost_cy2023": 1694769.59, "cohort_size": 6103 }, { "state": "OH", "matches": 18, "multi_source": 6, "medicaid_paid_post_deactivation": 1306525.7, "partb_paid_cy2023": 142229.57, "partd_drug_cost_cy2023": 609495.25, "cohort_size": 2669 }, { "state": "FL", "matches": 15, "multi_source": 5, "medicaid_paid_post_deactivation": 615271.0, "partb_paid_cy2023": 444976.52, "partd_drug_cost_cy2023": 1337001.07, "cohort_size": 4875 }, { "state": "TX", "matches": 11, "multi_source": 5, "medicaid_paid_post_deactivation": 107986.74, "partb_paid_cy2023": 89077.24, "partd_drug_cost_cy2023": 1522088.85, "cohort_size": 4873 }, { "state": "NJ", "matches": 7, "multi_source": 0, "medicaid_paid_post_deactivation": 91630.7, "partb_paid_cy2023": 39604.3, "partd_drug_cost_cy2023": 547936.52, "cohort_size": 2054 }, { "state": "MA", "matches": 7, "multi_source": 0, "medicaid_paid_post_deactivation": 421309.53, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 4562.04, "cohort_size": 2191 }, { "state": "IL", "matches": 6, "multi_source": 2, "medicaid_paid_post_deactivation": 479713.65, "partb_paid_cy2023": 115263.31, "partd_drug_cost_cy2023": 385655.03, "cohort_size": 2722 }, { "state": "GA", "matches": 6, "multi_source": 2, "medicaid_paid_post_deactivation": 816309.09, "partb_paid_cy2023": 132195.89, "partd_drug_cost_cy2023": 26206.79, "cohort_size": 1923 }, { "state": "LA", "matches": 6, "multi_source": 2, "medicaid_paid_post_deactivation": 393089.83, "partb_paid_cy2023": 98306.8, "partd_drug_cost_cy2023": 126475.23, "cohort_size": 1160 }, { "state": "MI", "matches": 6, "multi_source": 0, "medicaid_paid_post_deactivation": 70278.84, "partb_paid_cy2023": 26339.75, "partd_drug_cost_cy2023": 1586.54, "cohort_size": 2836 }, { "state": "NC", "matches": 5, "multi_source": 2, "medicaid_paid_post_deactivation": 1614941.07, "partb_paid_cy2023": 115686.85, "partd_drug_cost_cy2023": 42962.44, "cohort_size": 1907 }, { "state": "WA", "matches": 5, "multi_source": 0, "medicaid_paid_post_deactivation": 318886.41, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 409.82, "cohort_size": 1796 }, { "state": "CT", "matches": 5, "multi_source": 3, "medicaid_paid_post_deactivation": 66699.38, "partb_paid_cy2023": 44053.84, "partd_drug_cost_cy2023": 181399.9, "cohort_size": 968 }, { "state": "PA", "matches": 4, "multi_source": 3, "medicaid_paid_post_deactivation": 1570548.98, "partb_paid_cy2023": 81745.79, "partd_drug_cost_cy2023": 533153.73, "cohort_size": 3416 }, { "state": "OR", "matches": 3, "multi_source": 3, "medicaid_paid_post_deactivation": 530046.15, "partb_paid_cy2023": 11652.54, "partd_drug_cost_cy2023": 242637.94, "cohort_size": 1195 }, { "state": "OK", "matches": 3, "multi_source": 1, "medicaid_paid_post_deactivation": 456120.5, "partb_paid_cy2023": 8287.01, "partd_drug_cost_cy2023": 27555.0, "cohort_size": 1327 }, { "state": "VA", "matches": 3, "multi_source": 1, "medicaid_paid_post_deactivation": 74555.65, "partb_paid_cy2023": 177702.94, "partd_drug_cost_cy2023": 32116.42, "cohort_size": 1495 }, { "state": "MN", "matches": 3, "multi_source": 0, "medicaid_paid_post_deactivation": 194048.09, "partb_paid_cy2023": 18037.47, "partd_drug_cost_cy2023": 0, "cohort_size": 1107 }, { "state": "MO", "matches": 3, "multi_source": 1, "medicaid_paid_post_deactivation": 182506.32, "partb_paid_cy2023": 1422.85, "partd_drug_cost_cy2023": 0, "cohort_size": 1472 }, { "state": "MD", "matches": 3, "multi_source": 2, "medicaid_paid_post_deactivation": 63405.5, "partb_paid_cy2023": 136336.34, "partd_drug_cost_cy2023": 14139.51, "cohort_size": 1487 }, { "state": "NV", "matches": 3, "multi_source": 0, "medicaid_paid_post_deactivation": 250092.69, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 0, "cohort_size": 602 }, { "state": "NM", "matches": 2, "multi_source": 1, "medicaid_paid_post_deactivation": 490720.78, "partb_paid_cy2023": 465868.65, "partd_drug_cost_cy2023": 1241192.81, "cohort_size": 800 }, { "state": "KY", "matches": 2, "multi_source": 1, "medicaid_paid_post_deactivation": 135983.96, "partb_paid_cy2023": 74356.76, "partd_drug_cost_cy2023": 28049.08, "cohort_size": 1125 }, { "state": "IN", "matches": 2, "multi_source": 1, "medicaid_paid_post_deactivation": 98799.85, "partb_paid_cy2023": 1433.84, "partd_drug_cost_cy2023": 7138.01, "cohort_size": 1365 }, { "state": "HI", "matches": 2, "multi_source": 0, "medicaid_paid_post_deactivation": 39258.96, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 4490.02, "cohort_size": 316 }, { "state": "AZ", "matches": 2, "multi_source": 1, "medicaid_paid_post_deactivation": 13867.37, "partb_paid_cy2023": 1861.73, "partd_drug_cost_cy2023": 31992.24, "cohort_size": 1568 }, { "state": "CO", "matches": 2, "multi_source": 1, "medicaid_paid_post_deactivation": 1269.48, "partb_paid_cy2023": 15861.35, "partd_drug_cost_cy2023": 0, "cohort_size": 1306 }, { "state": "VT", "matches": 1, "multi_source": 1, "medicaid_paid_post_deactivation": 412749.4, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 120229.01, "cohort_size": 169 }, { "state": "PR", "matches": 1, "multi_source": 0, "medicaid_paid_post_deactivation": 104396.08, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 0, "cohort_size": 980 }, { "state": "AR", "matches": 1, "multi_source": 0, "medicaid_paid_post_deactivation": 97739.65, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 0, "cohort_size": 886 }, { "state": "NE", "matches": 1, "multi_source": 1, "medicaid_paid_post_deactivation": 17874.13, "partb_paid_cy2023": 43909.7, "partd_drug_cost_cy2023": 0, "cohort_size": 417 }, { "state": "SC", "matches": 1, "multi_source": 0, "medicaid_paid_post_deactivation": 0, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 56189.19, "cohort_size": 984 }, { "state": "RI", "matches": 1, "multi_source": 1, "medicaid_paid_post_deactivation": 38304.14, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 16415.61, "cohort_size": 318 }, { "state": "ME", "matches": 1, "multi_source": 0, "medicaid_paid_post_deactivation": 20381.89, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 0, "cohort_size": 432 }, { "state": "AL", "matches": 1, "multi_source": 0, "medicaid_paid_post_deactivation": 0, "partb_paid_cy2023": 18019.36, "partd_drug_cost_cy2023": 0, "cohort_size": 897 }, { "state": "WI", "matches": 1, "multi_source": 0, "medicaid_paid_post_deactivation": 0, "partb_paid_cy2023": 9379.68, "partd_drug_cost_cy2023": 0, "cohort_size": 1300 }, { "state": "WY", "matches": 1, "multi_source": 0, "medicaid_paid_post_deactivation": 8608.0, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 0, "cohort_size": 158 }, { "state": "AK", "matches": 1, "multi_source": 0, "medicaid_paid_post_deactivation": 7686.81, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 0, "cohort_size": 315 }, { "state": "WV", "matches": 1, "multi_source": 0, "medicaid_paid_post_deactivation": 3033.02, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 0, "cohort_size": 499 }, { "state": "KS", "matches": 1, "multi_source": 0, "medicaid_paid_post_deactivation": 1452.0, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 0, "cohort_size": 695 }, { "state": "DC", "matches": 1, "multi_source": 0, "medicaid_paid_post_deactivation": 367.05, "partb_paid_cy2023": 0, "partd_drug_cost_cy2023": 0, "cohort_size": 452 } ], "notes": "Per-state CSV at /api/v1/states//h31-deactivated-paid.csv. Match rule for Medicaid: CLAIM_FROM_MONTH > deactivation month/year (month-level precision). For Medicare Part B / Part D: deactivation_year < 2023 (year-level precision since the source files are CY 2023 aggregates). Multi-source matches are the strongest signal \u2014 same NPI billing across Medicaid + Medicare after NPPES deactivation is direct evidence of work being done under a closed identifier. State PI triage priority order: (1) multi-source matches, (2) Part D opioid prescribers, (3) high-dollar single-source matches." }