Gandhi v. Centers for Medicare and Medicaid Services

CourtDistrict Court, District of Columbia
DecidedMarch 30, 2023
DocketCivil Action No. 2021-2628
StatusPublished

This text of Gandhi v. Centers for Medicare and Medicaid Services (Gandhi v. Centers for Medicare and Medicaid Services) is published on Counsel Stack Legal Research, covering District Court, District of Columbia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gandhi v. Centers for Medicare and Medicaid Services, (D.D.C. 2023).

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

ASHVIN DHIREN GANDHI, et al.,

Plaintiffs,

v. Case No. 21-cv-2628 (CRC)

CENTERS FOR MEDICARE AND MEDICAID SERVICES,

Defendant.

MEMORANDUM OPINION

The central question in this case is whether the employer-identification numbers of health

care organizations and their parent companies are confidential records that may be properly

withheld from a Freedom of Information Act response. Answering no, and finding that release

of the records at issue will not risk inadvertent disclosure of more sensitive personal information

like social security numbers, the Court will grant summary judgment for Plaintiffs and against

the responding agency, the Centers for Medicare and Medicaid Services.

I. Background

Health care providers covered under the Health Insurance Portability and Accountability

Act (“HIPAA”) must obtain a unique identification number known as a National Provider

Identifier (“NPI”). Pls.’ Cross-Mot. Summ. J. & Opp’n to Def.’s Mot. (“Pls.’ Mot.”), Ex. 2 at 3,

5 (“NPI Explainer”). To receive an NPI, all providers—ranging from individual physicians to

organizations like hospitals and labs—must complete an application form and submit it to the

Centers for Medicare and Medicaid Services (“CMS”). Id. at 5, 7; Def.’s Mot. Summ. J. (“Def.’s

Mot.”), Ex. 6 ¶ 8 (“Gilmore Decl.”). The form contains numbered boxes calling for the

applicant’s name, address, and other identifying information. Pls.’ Mot., Ex. 10 (“NPI Application”). Individual providers, including sole proprietorships, are prompted to provide

their social security number or, in the case of an applicant who does not qualify for a social

security number, an Individual Tax Identification Number (“ITIN”). Id. at 1–3. Organizational

providers are asked to supply their Employer Identification Number (“EIN”), a type of tax-

identification number assigned to businesses by the Internal Revenue Service. Id. at 2–3. The

application form clearly instructs organizational applicants, in bold: “Do not report an SSN in

the EIN field.” Id. at 3. Organizational applicants, but not individuals, are also required to

indicate the tax-identification number of any “‘parent’ organization health care provider”

(“Parent TIN”). Id. (Not to be confused with an ITIN, the Parent TIN called for in the

application is, to be more precise, the EIN of the parent organization. An EIN, like a social

security number or an ITIN, is a specific type of tax-identification number issued by the IRS.)

The form further indicates that “information submitted on this application (except for Social

Security Number, IRS Individual Tax Identification Number, and Date of Birth) may be made

available on the internet.” Id.

CMS maintains NPIs, along with associated names and tax identifiers, in a database of

registered health care providers called the National Plan and Provider Enumeration System

(“NPPES”). Gilmore Decl. ¶¶ 8, 13. CMS periodically extracts fields from the NPPES

database showing basic identifying information for registered providers and makes them

available to the public in a downloadable spreadsheet file, id. ¶ 13, which Plaintiffs refer to as the

“full replacement monthly NPI File.” Pls.’ Mot., Ex. 12 ¶ 3 (“Gandhi Decl.”). CMS excludes

tax information, including the EIN, ITIN, and Parent TIN database fields, from the publicly

released file. Gandhi Decl. ¶ 3.

2 Plaintiffs Ashvin Gandhi and Samuel Antill are university professors researching

“whether the Department of Health and Human Services and CMS collect accurate data on the

ownership structures of health care providers.” Pls.’ Mot. at 15–16. In aid of that endeavor,

Plaintiffs filed a Freedom of Information Act (“FOIA”) request with CMS for “the unredacted

Employer Identification Number (EIN) and Parent organization Taxpayer Identification Number

(TIN) corresponding to all records in the full replacement monthly NPI File.” Pls.’ Mot., Ex. 1

at 1. Plaintiffs’ request did not seek social security numbers or any data pertaining to individual

health care providers or sole proprietorships.

After several searches, CMS identified responsive fields from the NPPES database for

some 1.6 million registered providers, but invoked FOIA Exemptions 4 and 6 to withhold all of

the records. Def.’s Reply & Opp’n to Pls.’ Mot. Summ. J., Ex. 3 ¶¶ 9–11 (“Gilmore Supp.

Decl.”). Further, CMS asserted that it could not release the requested EINs and Parent TINs

even if Exemptions 4 and 6 did not apply because some individual providers “may have”

mistakenly provided their social security numbers (or ITINs) in the parts of the NPI application

calling for organizational EINs or Parent TINs, and CMS has no way of removing those personal

identifiers from the database fields Plaintiffs seek. Gilmore Decl. ¶¶ 29–38.

The parties have filed cross-motions for summary judgment along with supporting

declarations. The Court heard oral argument on March 14, 2023.

II. Standard of Review

Summary judgment may be granted when the moving party establishes that there is no

genuine issue of material fact and that it is entitled to judgment as a matter of law. Fed. R. Civ.

P. 56(a). Summary judgment is the typical mechanism to determine whether an agency has met

its FOIA obligations. See, e.g., Judicial Watch, Inc. v. CFPB, 60 F. Supp. 3d 1, 6 (D.D.C. 2014).

3 Under FOIA, an agency is first required to make an adequate search for any responsive

records. 1 See Rodriguez v. U.S. Dep’t of Def., 236 F. Supp. 3d 26, 34 (D.D.C. 2017). In

addition to demonstrating that it conducted an adequate search, the agency must also justify any

withholdings it has made pursuant to a FOIA exemption. See, e.g., Larson v. Dep’t of State, 565

F.3d 857, 862 (D.C. Cir. 2009). Justification can be provided through sufficiently detailed

agency affidavits, see, e.g., id., which are “accorded a presumption of good faith.” SafeCard

Servs., Inc. v. SEC, 926 F.2d 1197, 1200 (D.C. Cir. 1991). Because the primary purpose of

FOIA is disclosure, exemptions are construed narrowly. See, e.g., DiBacco v. U.S. Army, 795

F.3d 178, 183 (D.C. Cir. 2015).

FOIA also requires “[a]ny reasonably segregable portion of a record [to] be provided to

any person requesting such record after deletion of the portions which are exempt . . . .” 5

U.S.C. § 552(b). Thus, “non-exempt portions of a document must be disclosed unless they are

inextricably intertwined with exempt portions.” Mead Data Cent., Inc. v. Dep't of Air Force, 566

F.2d 242, 260 (D.C. Cir. 1977). Agencies must provide “the reasons behind their conclusions”

that non-exempt material is not reasonably segregable. Id. at 261. “Nevertheless, ‘[a]gencies are

entitled to a presumption that they complied with the obligation to disclose reasonably

segregable material,’ which must be overcome by some ‘quantum of evidence’ by the requester.”

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