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Reportable to the NPDB? What is the NPDB?

January 15, 2013
Question:

Hi Jennifer,
 
I recently had a dispute with a hospital I was affiliated with and ended up leaving on poor terms. Is this something that can end up being reported to the NPDB?

Dr. A

Answer:

Depends on the nature of the "dispute" with your hospital.  By way of background for those reading who do not know what the NPDB is, the National Practitioner Data Bank, first established by the Health Care Quality of Improvement Act of 1986, is an alert system intended to facilitate the review of practitioner credentials, and is managed by HHS. Many physicians are aware that malpractice awards are reported to the NPDB; less known is that other professional credentialing, licensure, compliance, and privileging actions are also recorded in the databank.

Generally the following type of information is reportable to the NPDB:

• Adverse licensure actions (revocation, reprimand, censure, suspension, probation, etc.)
• Adverse clinical privileging actions
• Adverse professional society membership actions
• Any negative action or finding by a State licensing or certification authority
• Peer review organization negative actions
• Private accreditation organization negative actions or findings
• Medicare and Medicaid exclusion reports

Hospitals do report to the NPDB, and as you can see adverse privileging actions are reportable; but whether or not this specific dispute is reportable depends on the specific facts of the matter. If the hospital’s privileging committee made an adverse determination regarding your privileging status, there is a good chance it may end up reporting it to the NPDB. For this reason, it is advisable that any separation be covered by an agreement detailing each party's obligations, including confidentiality, if possible.  

If you have been reported to the NPDB, it may result in a blemish on your record - however be advised that while hospitals and other health care entities with a formal peer review process may conduct NPDB queries, patients and most providers are not authorized to do so.

Generally the NPDB notifies doctors when a report is filed. If you still are concerned about your NPDB report you can perform a self-query at the NPDB’s website, available here: http://www.npdb-hipdb.hrsa.gov/pract/hasAReportBeenFiledOnYou.jsp, where you will also have an opportunity to respond or challenge an incorrect report.  If you require assistance with an incorrect report, let us know.

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