Hospitals are mandated by federal law to query the National Practitioner Data Bank (“NPDB”) on the status of physicians, dentists and other health care practitioners who apply for medical staff appointment or clinical privileges. Other health care entities and societies are permitted to query the NPDB on the available information as well. It is not uncommon for practitioners to face reporting incidents during their careers, and many times it is unclear whether an event will be reportable until it is too late. For example, voluntarily relinquishing or resigning privileges while under investigation or at the commencement of an investigation, is in fact reportable. Therefore, practitioners who consider resigning their privileges in an effort to avoid an investigation or suspension, may be doing themselves a disservice and/or causing more harm. The importance of monitoring report narratives and understanding one’s rights is crucial.
The NPDB is a source of information intended to assist participating entities in formulating decisions regarding licensure, employment, contracting, membership, clinical privileges or the conducting of investigations. When a report is submitted to the NPDB, the confidential information disclosed by the health care entity is permanently preserved within the NPDB clearinghouse. Reports are made by NPDB participants, which is mainly comprised of healthcare entities, that relate to medical malpractice payments and certain adverse actions taken by the entities against practitioners. Adverse actions include suspension and termination of clinical privileges, mandatory proctoring and supervision, and/or limitation of privileges. Initial reports are usually submitted when the adverse action is commenced by the hospital, with supplemental reports filed at the conclusion of a hearing and final determination made by the hospital’s peer review organization.
Ensuring that adverse reports are confronted immediately can be vital to a practitioner’s career. More importantly, understanding the reporting system and striving to avoid reportable events in their entirety is critical. Qualifying entities, specifically authorized by legislation, are permitted to submit queries to the NDPB to obtain reports reflecting negative actions or findings by peer review organizations, state licensure of certification actions, health care related civil judgments in state court, state court criminal convictions or other adjudicated actions or decision. The existence of permanent reports of misconduct can impede a physician’s ability to freely practice medicine or obtain privileges at certain hospitals.
Frier Levitt has extensive experience representing healthcare providers with respect to NPDB reporting. Whether it is a matter of preemptively avoiding reporting altogether or negotiating a resolution to an adverse action, our support for many physicians has proven to be invaluable. A report with the NPDB is not a conclusive bar to obtaining privileges or employment, however it is important to carefully navigate all options when NDPB reports occur. Contact us today to learn more about how to properly navigate and mitigate the impacts of NPDB reporting.
