National Practitioner Data Bank
The National Practitioner Data Bank (NPDB), which collects information to identify adverse or disciplinary actions taken against physicians, dentists and other health care practitioners, is primarily an alert or flagging system. It is meant to be a system for inquiry into specific areas, such as a practitioner's license and professional membership status, malpractice payment history and record of clinical privileges. The NPDB is a tool to assist but not replace review of a practitioner's credentials.
The NPDB considers all reporting to be confidential and shall not disclose said information except as specified in the regulations. The NPDB collects and disseminates to eligible entities, reports of: medical malpractice payments of any amount, adverse licensure actions, adverse clinical privileging actions, and adverse professional society membership actions. This information is available to:
- Hospitals requesting information on practitioners to whom they are granting clinical privileges.
- Health care entities that are considering entering into an employment arrangement with or to which the practitioner has applied for clinical privileges.
- Practitioners requesting information about themselves.
- Boards of medical examiners or other state licensing boards.
- Persons or entities requesting information in a form which does not identify any particular entity or practitioner.
The general public may not request information from the NPDB that identifies any particular entity or practitioner. Nor can a medical malpractice payer request information even though they are required to report.
There is often confusion about the specific reporting requirements for dentists who have had their liability carrier issue a payment under their professional liability policy resulting from a written demand or malpractice claim or for dentists who have received adverse peer review decisions. While settlement of a malpractice claim can occur for many reasons, which are not always related to the competency or conduct of a practitioner, a malpractice carrier is obligated to report any payment made on behalf of its insured. Payment of a professional liability claim does not always indicate malpractice actually occurred. The table below should assist in explaining the reporting requirements for the NPDB.
|Entity||Action||Reportable to NPDB?|
|Professional liability carrier||Malpractice settlement||Yes|
|Professional liability carrier||Court judgment||Yes|
|Peer review||Malpractice carrier pays claim underlying the peer review action||Yes|
|Peer review||Doctor pays claim underlying the peer review action||Yes, if paid from business account|
|Peer review||Doctor pays claim underlying the peer review action||No, if paid from personal account|
|Individual refund||Verbal agreement||No|
|Individual refund||Written agreement||Yes, if paid from business account|
|Individual refund||Written agreement||No, if paid from personal account|
|Professional society||Conduct adversely affects membership||Yes|
|Dental board||Adverse license actions||Yes|
|Hospital or health care entities||Adverse conduct affecting clinical privileges for more than 30 days||Yes|
For more information about reporting to the National Practitioner Data Bank, call the Data Bank Help Line at 800.767.6732. To speak with an information specialist, call Monday through Thursday, 8:30 a.m. to 6 p.m. ET; or Friday, 8:30 a.m. to 5:30 p.m. ET. Recordings on common topics and Data Bank developments are available seven days a week, 24-hours a day.
Information is also available on the NPDB Web site.