Health care providers must know about this national database

On Behalf of | Jun 9, 2020 | Professional License Issues |

Medical professionals licensed in Pennsylvania should be familiar with the National Practitioner Data Bank.

The American Bar Association explains that the U.S. Department of Health and Human Services maintains this data bank, which is a national repository for reports of disciplinary actions against health care professionals.

The NPDB is a clearinghouse for reports affecting health care providers

The NPDB collects disciplinary reports from numerous organizations in the health care field. Organizations that submit reports to this database include federal and state government agencies, state medical boards, medical malpractice payers, hospitals, health plans and peer review associations.

Doctors have access to review reports alleging adverse actions. If a report is inaccurate, the doctor must ask the reporting party to make a correction. Doctors also have the option to add a statement that explains the events described in the report.

Physicians can also check to determine which entities have received a copy of any NPDB report. Having access to this information may allow doctors to assess whether they face future credentialing roadblocks. Doctors charged with a crime should request a self-query report.

When a state expunges disciplinary records, removal of the records from the state’s database does not automatically trigger removal of reports from the NPDB. However, a provider may seek removal if an appeal overturns or reverses disciplinary action.

The NPDB demands certain types of information

According to the NPDB’s website, it gathers information and preserves reports about a number of reported incidents:

  • Federal or state actions relating to licensure or certification
  • Medical malpractice payments
  • Actions that prohibit participation in federal or state entitlement programs like Medicare or Medicaid
  • Criminal convictions and civil judgments related to health care
  • Adverse actions that affect clinical privileges or professional association memberships

Certain organizations and individuals must report adverse actions against health care providers to the NDPB and may face sanctions for failing to report.