DowncodedWho CMS Hired to Make the Provider Record True
CMS signed a $77.6 million contract on September 24 for the ground truth under its National Provider Directory, and the winner was H1, a New York small business with no prior federal prime award and three provider-data acquisitions in twenty months. Five days later the directory reloaded: 14.2 million rows gone, every surviving row flagged active, and a Medicare Advantage plan-and-network layer that was not there in August.
If you pulled counts off the federal provider directory in August, throw them away.
CMS reloaded it on September 29 and the thing that came back is 14,175,904 records smaller than the one this desk counted on August 5.
Five days before that reload, CMS signed a contract for the job of making those records true.
The Company With No Federal Past
The award is 75FCMC26C0030, signed September 24, and it went to H1 Insights, Inc. of 373 Park Avenue South in Manhattan.
$15,979,145 obligated on day one. $77,635,070.70 if CMS exercises every option, which carries the work to September 24, 2031.
Firm fixed price, performance-based, full and open competition, no set-aside, and 13 offers on solicitation 75FCMC26R0063.
Now the part worth sitting with. Search the federal spending record for every prime award H1 Insights has ever held, contracts and IDVs both, back to 2007, and you get one result.
This one.
A small business in the federal size standards, with nothing in the award history behind it, took the ground-truth data work under the directory CMS is building.
It did not arrive from nowhere, though. H1 has spent twenty months buying the provider-data bench:
- Ribbon Health, announced January 8, 2025
- Veda, announced June 3, 2025, under a headline that named the problem out loud ("to Solve Healthcare's Provider Data Challenge")
- Defacto Health, announced September 9, 2026, for payer and provider data that lets a plan "assess directory accuracy, isolate error clusters, and benchmark networks"
H1 announced Defacto 15 days before CMS signed. Its co-founder, Ron Urwongse, is the H1 executive quoted on the award.
And in May, CVS Health Ventures led a $40 million round into the company.
What CMS Actually Bought
Two scope areas, in H1's words: Ground Truth Data Sourcing and Licensing, and Data Aggregation, Quality, and Assurance Services. Sourcing and licensing authoritative provider data, normalizing and validating records, correcting them.
CMS wrote its own version into the contract file: professional IT services for a directory "intended to transition from current state managed directories to a NPD to serve as a critical foundat" (the federal procurement system truncates the field at 250 characters, so the sentence ends there).
The fuller statement of intent is in a CMS memo to Medicare Advantage organizations dated November 7, 2025, the technical guide behind CMS-4208-F2:
"Phase Three - CMS has begun the development of a National Provider Directory that will serve as connective tissue between healthcare providers, payers, data networks, and their respective interoperability frameworks."
That memo also sets Phase Two: for CY 2027, CMS ingests in-network provider and facility data straight from the directory APIs that MA plans build and maintain, in FHIR JSON or machine-readable JSON.
Worth noting what the agency spent to get here. The four predecessor awards, all signed the same day in September 2025, were proof-of-concept orders to Palantir, Availity, CAQH and Gainwell at $1.00 apiece.
Four dollars of proof of concept, then $15,979,145.
What the Reload Did
The reload changed what the directory is willing to publish.
In August, 16,997,111 of the 21.1 million PractitionerRole rows came back on ?active=false, along with 244,846 inactive Practitioner records. Call it 17,241,957 rows describing affiliations and clinicians the federal record no longer stood behind.
Query the same two resources today and ?active=false returns zero on both. Same for Organization, same for Location (chart below).
The survivors are a bigger set than August's active half, too. Active PractitionerRole went from 4,106,116 to 7,710,405, up 88%, while the resource as a whole shed 13.4 million rows.
The API grew with it. Eight resource types now instead of six, a verification-status search parameter on every one of them, and network, new-patient and new-patient-from-network parameters that did not exist two months ago.
The server renamed itself from "NPDP Provider Directory FHIR R4 API" to "National Provider Directory FHIR R4 API" in the same release.
The Layer That Wasn't There in August
Two of those eight resource types are new, and InsurancePlan is the one to look at.
233 records, 27 Medicare Advantage contract IDs, 8 distinct owner names, 47 distinct network references. Each row carries the H number and PBP in its alias (H8173-020-000), a plan year, an owner, and a pointer to the network the plan sells.
19 of the 233 are already dated to plan year 2027.
So the federal record is starting to hold the link a revenue-cycle department pays people to maintain by hand: this plan, that network, these providers. Devoted Health, Healthfirst, Freedom Health and Optimum Healthcare are in it so far, plus two the directory names only as BSC and BCBSRI.
It is an early load, and it reads like one. The free-text plan type field carries nine different strings across 233 rows, from "Medicare Advantage PPO Plan" to "mediadv" to "medi".
Which is a fair description of the contract H1 just signed.
Final Thoughts
None of this is a tool you can run a denial through yet. The verification-status parameter is advertised and does not answer, the plan layer covers eight named organizations, and the quality work is on a clock that runs to 2031.
What changed on September 29 is that the federal provider record started subtracting. An agency that ships 17 million rows flagged inactive is building a reference file; an agency that ships none of them is building a source of truth, and has now put $77.6 million behind the difference.
Go query your own NPIs at directory.cms.gov/fhir. It is open, it needs no key, and your affiliation rows moved.
Thanks for reading.