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Medical Malpractice Payments Reporting Requirements Teleconference

The Medical Malpractice Payments Reporting Requirements Teleconference was held on April 14, 2021.

Event Materials: Medical Malpractice Payments Reporting Requirements Teleconference presentation slides (PDF - 434 KB)

Q&As

  1. If we are the provider staffing group, must our credentialing department submit malpractice actions?
    Any organization that makes a payment for the benefit of a health care practitioner in settlement of, or in satisfaction in whole or in part of, a written claim or judgment for medical malpractice against that practitioner must report the payment information to the NPDB. See the NPDB Guidebook section on Reporting Medical Malpractice Payments for additional information. Consequently, if your organization makes such a payment, it must submit an MMPR to the NPDB. Your organization must decide what department should submit the MMPR, and your organization must be properly registered with the NPDB to do so.
  2. Are insurance companies responsible for reporting settlements in medical malpractice cases to the NPDB?
    Yes. If an insurance company makes a payment on behalf of a named or clearly identified practitioner in a medical malpractice dispute in response to a written demand for payment, the insurance company must report that payment to the NPDB.
  3. How soon after a malpractice case is settled is an insurance company required to report the payment to the NPDB?
    NPDB regulations require that an organization submit an MMPR within 30 days after a malpractice payment is made.
  4. Can a report be submitted late if it is discovered it wasn't timely filed?
    Yes. All required reports must be filed with the NPDB regardless of whether they are late. The secretary of Health and Human Services may conduct an investigation if there is reason to believe an entity substantially failed to report required medical malpractice payments or adverse actions.
  5. If a payment is issued by an insurance company but is not reported to the NPDB, is it the responsibility of other reporting bodies who are aware of the outcome to report? For example, we are a reporting practice, but our physicians handle their claims via their specific malpractice policies. We receive notifications of outcomes, and we have found that not all settlements have been reported. Are we responsible for reporting?
    The entity that makes a payment for the benefit of the practitioner in the settlement of a Malpractice Claim is legally responsible for submitting a Report to the NPDB. However, if you are aware of an insurance company or self-insured entity not reporting a payment on behalf of a practitioner in the settlement of a Malpractice Claim, we ask that you notify the NPDB.
  6. If a physician pays a settlement from personal funds, should an MMPR be submitted?
    No. Payments made from a practitioner's personal funds are not reportable to the NPDB. However, a professional corporation or other entity composed of a sole practitioner that makes a payment for the benefit of that named practitioner must report the payment.
  7. If a covered practitioner is not specifically named as a defendant but is identified in the complaint as a provider, would a settlement payment be reportable?
    If a practitioner is named, identified, or described in the body of the written complaint or claim and is not named as a defendant in the suit, the payment would be reportable if (1) the practitioner also is named, identified, or described in the settlement or final judgment and (2) a payment was made on behalf of the named, identified, or described practitioner.
  8. When a medical malpractice settlement involves multiple practitioners, could one report cover all of the named practitioners?
    No. A separate Medical Malpractice Payment Report must be submitted for each named practitioner.
  9. I query the NPDB for every initial appointment and reappointment my organization makes. Must a provider reveal the existence of a pending lawsuit?
    The NPDB does not provide guidance or direction pertaining to the specific information a practitioner is required to provide in the course of an independent appointment or reappointment process. Each organization can determine the required information applicants provide in the appointment process.
  10. Are there any medical malpractice practice settlement reports that capture average payouts per injury?
    This information is available in NPDB's Data Analysis Tool (DAT) and Public Use Data File (PUF). The DAT allows users to generate datasets for Adverse Action Reports and Medical Malpractice Payment Reports. The PUF contains information on specific variables taken from Adverse Action Reports and Medical Malpractice Payment Reports received by the NPDB on licensed health care practitioners, as well as information from reports of Medicare and Medicaid exclusion actions. This file is updated quarterly and is designed to provide data for statistical analysis only.

For additional common questions and answers about MMPR reporting, see the NPDB Guidebook section Q&A: Reporting Medical Malpractice Payments.

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