A West Virigina physician sued a hospital alleging defamation and antitrust violations. The physician, an independent pain management specialist, claimed that the hospital improperly suspended the physician’s privileges based on false allegations that the physician abused a patient during a procedure. However, the hospital, contended that the physician lost privileges after a nurse filed a patient safety complaint resulting in a hospital investigation and peer review that led to a subsequent report to the National Practitioner Data Bank (“NPDB”). The NPDB is a federal clearinghouse that maintains confidential information relating to, among other things, adverse actions taken against healthcare practitioners. The practical result of a report to the NPDB is a permanent record of an adverse action which is subsequently available to certain registered entities, such as hospitals, insurance carriers and state licensing boards.
Upon bringing this action, the physician agreed to enter into settlement discussions with the hospital to avoid further litigation. As part of the settlement agreement, the physician accepted a $300,000 settlement with the condition that the NPDB report be retracted. The physician subsequently tried to rescind the settlement due to the hospital’s failure to retract the NPDB report. Nonetheless, the West Virgina Judge enforced the settlement given that the physician’s condition precedent to the settlement was an impossibility, due to the hospital having no legitimate basis to withdraw the NPDB report under federal regulations. An NPDB reporting can only be withdrawn if the report was submitted in error, the disciplinary action wasn’t actually reportable or if the disciplinary action was upended on appeal. The Judge’s decision recognized that in this instance, the hospital had an obligation to make the report and had no authority to have it subsequently removed. The withdrawal of the NPDB reporting as a prerequisite to enforcement of the agreed upon settlement, lacked legitimate basis under federal law and therefore was denied by the court.
Navigating the intricacies of the NPDB can be a challenging undertaking, especially in instances that trigger reportable incidents. A negative NPDB report can severely impact a physician’s employment prospects and eligibility for clinical privileges. When reportable incidents are recorded, it is imperative that physicians address their options immediately. The NPDB maintains reported information permanently unless corrected or voided from the NPDB by the reporting entity or by the NPDB through the Dispute Resolution process. While it is highly uncommon for reports to be removed in their entirety, supplements or reporting corrections are permitted and can reduce the severity of the negative impact reporting causes. Therefore, it is crucial that the practitioners seek the guidance of a healthcare attorney to ensure their interests are best protected.
Frier Levitt has extensive substantial experience representing physicians and healthcare providers in NPDB reporting matters, including challenges, suspensions and termination of privileges, and negotiating with healthcare entities to resolve adverse actions. Our main goal is facilitating resolutions between healthcare entities and providers. Contact us to learn more about navigating and mitigating the impact of NPDB reporting.
