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NPDB Reportable Events Expanded?

Provided by:  Jennifer Kirschenbaum, Esq.

April 19, 2018

 

Question:

Hi Jennifer, 

Have there been any recent changes on what is reportable to the NPDB?  I thought I saw something. 

Thanks, Dr. P


Answer:

I asked Michael Foster, Esq. to take this one.  Here is what Michael came up with -

Yes, good question.  The list of what is reportable to the National Practitioner Data Bank has changed, and while only seemingly slight, definitely impactful. The fact that Hospitals must file a National Practitioner Data Bank (“NPDB”) report on any physician's surrender of privileges if an investigation is underway has always been a Data Bank reporting requirement, intended to discourage settlements which allowed physicians to avoid being reported if they agreed to waive hearing rights.  However under the new Guidebook released by the NPDB, now we have expanded descriptions of "investigation" and "surrender" which elaborate on what is to be considered a reportable surrender of privileges.
 
According to the new Guidebook an investigation begins as soon as the health care entity begins an inquiry and does not end until the health care entity’s decision-making authority takes a final action or makes a decision to not further pursue the matter. A routine, formal peer review process under which a health care entity evaluates, against clearly defined measures, the privilege-specific competence of all practitioners is not considered an investigation for the purposes of reporting to the NPDB. However, if a formal, targeted process is used when issues related to a specific practitioner’s professional competence or conduct are identified, this is considered an investigation for the purposes of reporting to the NPDB.

For example if an investigation was under way when the physician surrendered his privileges, even if the physician was not aware of the investigation, the surrender would have to be reported even if the physician claimed he surrendered the privileges for unrelated personal reasons. Most medical staff policies and bylaws in hospitals today do not reflect these changes and will need to be reworked under the new NPDB Guidebook.

For anyone subject to a potential reporting - make sure to contact our office asap so we can help you avoid a reporting.  And, if you have already been reported we can help with your statement you may post on the NPDB on your own behalf, as well as help with future statements explaining the report.  

Hope this helps!  I'm available to discuss. 

Michael Foster, Esq. 
MFoster@Kirschenbaumesq.com
(516) 747-6700 x. 308
 


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