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NPDB Insights - August 2018

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Is It Reportable?

A defendant health care practitioner settled a medical malpractice claim in exchange for dismissal from a lawsuit. All parties involved in the lawsuit agreed to the condition. Should the resulting payment be reported to the NPDB?

Yes. Because the payment is the result of the condition that the defendant health care practitioner be dismissed from the lawsuit, the payment can only be construed as a payment for the benefit of the health care practitioner and must be reported to the NPDB.

Health Plans to Join the Attestation Effort

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Attestation is our national education and outreach effort to ensure that all eligible entities are meeting their NPDB reporting requirements as mandated by federal law. During attestation, Data Bank administrators or other entity officials attest that their organizations have submitted all reportable adverse actions and medical malpractice payments to the NPDB.

This month, health plans join hospitals, health centers, and state licensing boards in this effort. Attestation confirms that your health plan has met its reporting obligations. Complete and accurate reporting to the NPDB provides queriers with the information needed for credentialing, privileging, and employment decisions that directly affect patient safety.

Attestation occurs when you renew your organization's NPDB registration. If your organization is asked to attest, detailed instructions will appear when you sign into your account to renew. The NPDB will send reminder emails 60, 30, and 5 days before registration renewal. To prepare for attestation, your organization can review its records and ensure you have submitted all reportable adverse actions and medical malpractice payments.

For additional information, please visit the Health Plan page.

Understanding Adverse Action Reports

Do you know which common actions you should submit as an Adverse Action Report (AAR)?

You should submit an AAR when taking any reportable action against a health care practitioner, organization, provider, or supplier, other than a medical malpractice payment or a judgment/conviction. A list of adverse actions you should submit as an AAR can be found in the NPDB Guidebook. Some of the most common actions reported as AARs are listed below:

  • Clinical Privileges Actions
    A hospital initiates an investigation into whether a doctor's conduct could endanger the well-being of patients. Before being informed of the investigation, the physician voluntarily surrenders his clinical privileges. Should the hospital report to the NPDB?
    Yes. Since the hospital initiated the investigation due to concerns that a doctor's conduct could adversely affect patient welfare, this surrender is reportable.

  • Licensure Actions
    After investigating several patient complaints about a nurse, the Board of Nursing for a state requires the nurse follow a corrective action plan but otherwise took no additional action against her license. The state licensing board sees the corrective action plan as a negative action connected to the delivery of health care services. Should the action be reported to the NPDB?
    Yes. This corrective action plan is reportable because it is connected to the delivery of health care services as determined by the state where the nurse is licensed. A negative action or finding that is publicly available information and is rendered by a licensing or certification authority is reportable.

  • Professional Society Membership Action
    A professional society's peer review committee suspends a doctor's membership based on a state licensing board's action to place the doctor's license on probation for reasons related to professional conduct that could adversely affect the health or welfare of a patient. Is this reportable?
    Yes. If an action taken by the professional society adversely affects a physician's or dentist's membership, it must be reported to the NPDB when that action is taken during a formal peer review process. The action must be based on the member's professional competence or conduct that could adversely affect the health or welfare of a patient.

To learn more about what you're required to report, visit the What You Must Report to the NPDB page.

Customer Service Center Quick Tip

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Are you regularly getting locked out of your account while using credentialing software to access the NPDB?

NPDB passwords expire every 60 days. If you try to use your credentialing/third-party system with an expired NPDB password, your account will be locked. The Customer Service Center recommends updating your password on the NPDB website first and then updating it in your credentialing system to avoid being locked out.

Many credentialing systems have a process that runs in the background to automatically obtain NPDB files. This process must be turned off before changing the password. Once the passwords between the two systems synchronize, you can then turn the process back on.

For more information, visit our Credentialing Software FAQs.

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Previous editions of NPDB Insights are available in our archive.