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Unified Medical Language System® (UMLS®)

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Statement of Account Instructions

Submitting the Statement of Account

Affiliates reporting directly to the NLM may submit their completed report by:

  1. Email to nichsr@nlm.nih.gov with a subject line “IHTSDO Affiliate Statements” or
  2. FAX a paper copy to: 301-402-3193 or
  3. Mail a paper copy to:
    National Information Center on Health Services Research and Health Care Technology (NICHSR)
    National Library of Medicine
    ATTN: IHTSDO Affiliate Statements
    8600 Rockville Pike
    Building 38A, Room 4S-410, Mail Stop Code 3833
    Bethesda, MD 20894

To avoid late penalties, the Statement of Account must be received by January 31, 2011.

Completing the Statement of Account Form

Except as noted in the instructions, all fields in Parts A-D must be completed.

Part A: Affiliate License Summary

  1. Affiliate Name: Name of the person or organization that holds the Affiliate License (the Licensee)
  2. Affiliate License Date: Date that the Licensee first obtained an Affiliate License (aka the date the UMLS License was issued by NLM)
  3. Licensing Authority: Select the Licensing Authority from which the Affiliate received its Affiliate License; in most cases, this will be an IHTSDO Member country as listed below:
IHTSDO Licensing Authority
IHTSDO Member Licensing Authority
Australia National E-Health Transition Authority (Australia)
Canada Canada Health Infoway
Cyprus Ministry of Health of the Government of Cyprus (Cyprus)
Denmark National Board of Health (Denmark)
Estonia Estonian eHealth Foundation
Lithuania Ministry of Health (Lithuania)
The Netherlands Ministry of Health, Welfare and Sport (Netherlands)
New Zealand New Zealand Ministry of Health
Singapore MOH Holdings Pte Ltd (Singapore)
Slovak Republic National Health Information Center
Slovenia Ministry of Health (Slovenia)
Spain Ministry of Health and Consumer Affairs (Spain)
Sweden Ministry of Health and Social Affairs (Sweden)
United Kingdom NHS Connecting for Health (United Kingdom)
United States National Library of Medicine (USA)
IHTSDO IHTSDO is the Licensing Authority for all Non-Member territories; IHTSDO is the Licensing Authority for other Affiliate Licensees other than those who currently have in-scope licenses with CAP STS.

Note - the IHTSDO is the Licensing Authority for all Non-Member territories

  1. Current Reporting Period: Indicate the previous 6-month period and year, for which this Statement of Account is being submitted.
  2. Affiliate Account #: Enter the Account # (UMLS License Code)

Part B: Affiliate Contact Details

  1. Registered Address: Registered or official address of the Affiliate; indicate if the address has changed
  2. Billing Address: Address to which invoices or other communications relating to the Statement of Account should be delivered
  3. Billing and Administrative Contact: Individual to whom communications relating to the Statement of Account should be directed, and who is authorized to receive official Notices on behalf of the Affiliate

Part C: Activity Report

Please refer to Appendix B of the Affiliate License (Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus) for definitions and other information useful in completing Part C and the Worksheets.

Question 1. If the Affiliate engaged in any Licensed Uses of the SNOMED CT International Release in Non-Member Territories during the Current Reporting Period: Mark “Yes” and proceed to Question #2

   Otherwise: Mark “No” and skip to Part D.

Question 2. If the Licensed Uses in Question #1 consisted solely of the creation, distribution and licensing of Derivatives and Third-Party Extensions: Mark “Yes” and skip to Part D.

   Otherwise: Mark “No” and proceed to Question #3

Question 3. If the Licensed Uses in Question #1 included the deployment, distribution or licensing of Data Creation Systems (as defined in the Affiliate License - Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus): Mark “Yes”, complete Worksheet 1, and proceed to Question #4

   Otherwise: Mark “No” and proceed to Question #4

Question 4. If the Licensed Uses in Question #1 included the deployment, distribution or licensing of Data Analysis Systems (as defined in the Affiliate License - Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus): Mark “Yes”, complete Worksheet 2, and proceed to Question #5

   Otherwise: Mark “No” and proceed to Question #5

Question 5. If the Licensed Uses in Question #1 included any other use of the International Release of SNOMED CT for which fees may be owed to the IHTSDO: Mark “Yes”, complete Worksheet 3, and proceed to Part D

   Otherwise: Mark “No” and proceed to Part D

Part D:

The completed Statement of Account must be signed by the appropriate individual before being submitted to the appropriate Licensing Authority email. Contact information for Affiliate Licensing Authorities is provided at the end of this document.

Worksheet 1: Data Creation System

Please refer to Appendix B of the Affiliate License (Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus) for definitions and other information necessary to complete Worksheet 1.

  1. Each Non-Member Territory where the Affiliate has been involved in the deployment, distribution or licensing of Data Creation Systems (as defined in the Affiliate License) during the Current Reporting Period should be listed on a separate line. This includes both new Data Creation Systems deployed, distributed, or licensed during the period, along with the ongoing licensing of systems previously deployed or distributed.
  2. For each Non-Member Territory listed, enter the Fee Band (A, B or C ) established by the IHTSDO for that territory. If the territory is a Sponsored Territory, enter “S”. The current list of Fee Band assignments is detailed in the Affiliate License Fee Band Assignments document.

    If some, but not all, of the Affiliate’s Data Creation Systems within a Non-Member Territory were part of one or more Qualifying Research Projects, use a separate line for those activities and enter “R” as the Fee Band.

    If the Affiliate has received a humanitarian or charitable waiver from the IHTSDO for some, but not all, of its Data Creation Systems within a Non-Member Territory, use a separate line for those activities and enter “W” as the Fee Band.
  3. For each line on the Worksheet with a Non-Member Territory listed on the Worksheet, enter the applicable number of Hospital and Practice systems. Refer to Appendix B of the Affiliate License (Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus) for definitions of those terms and rules related to the calculation of the number of Practices within one Hospital.

Worksheet 2: Data Analysis System

Please refer to Appendix B of the Affiliate License (Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus) for definitions and other information necessary to complete Worksheet 2.

  1. Each Non-Member Territory where the Affiliate has been involved in the deployment, distribution or licensing of Data Analysis Systems (as defined in the Affiliate License - Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus) during the Current Reporting Period should be listed on a separate line. This includes both new Data Analysis Systems deployed, distributed, or licensed during the period, along with the ongoing licensing of systems previously deployed or distributed.
  2. For each Non-Member Territory listed, enter the Fee Band (A, B or C) established by the IHTSDO for that territory. [Note - different versions of the same database counts as one.] If the territory is a Sponsored Territory, enter “S”. The current list of Fee Band assignments is detailed in the Affiliate License Fee Band Assignments document.

    If some, but not all, of the Affiliate’s Data Analysis Systems within a Non-Member Territory were part of one or more Qualifying Research Projects, use a separate line for those activities and enter “R” as the Fee Band.

    If the Affiliate has received a humanitarian or charitable waiver from the IHTSDO for some, but not all, of its Data Analysis Systems within a Non-Member Territory, use a separate line for those activities and enter “W” as the Fee Band.
  3. For each line on the Worksheet with a Non-Member Territory listed on the Worksheet, enter the applicable number of Databases deployed, distributed or licensed in that territory.

Worksheet 3: License Fees for Other Activities

Please refer to Appendix B of the Affiliate License (Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus) for definitions and other information necessary to complete Worksheet 3.

  1. If the Affiliate engages in any Licensed Uses of SNOMED CT in Non-Member Territories that are not otherwise covered by the Affiliate License Fee structure, they must be included on Worksheet 3.
  2. Note that under the terms of the Affiliate License (Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus), the IHTSDO must approve such Licensed Uses in advance, at which time it will establish an appropriate License Fee structure for the activity in question.
  3. For each type of Licensed Use in a Non-Member Territory, enter sufficient information to describe the activity, the territories where the activity took place and the IHTSDO-approved calculation of License Fees for the activity.

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Last Reviewed: December 23, 2010