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Overview Submitting Reports to the NPDB Reporting Medical Malpractice Payments Reporting Adverse Clinical Privileges Actions Reporting Adverse Professional Society Membership Actions Reporting State Licensure and Certification Actions Reporting Federal Licensure and Certification Actions Reporting Peer Review Organization Negative Actions or Findings Reporting Private Accreditation Organizations Negative Actions or Findings Reporting Exclusions from Participation in Federal and State Health Care Programs Reporting Federal or State Health Care-Related Criminal Convictions Reporting Health Care-Related Civil Judgments Reporting Other Adjudicated Actions or Decisions

Chapter B: Eligible Entities

Overview

The NPDB is an information clearinghouse created by Congress with the primary goals of improving health care quality, protecting the public, and reducing health care fraud and abuse in the United States. To facilitate comprehensive reviews of the credentials of health care practitioners, entities, providers, and suppliers, eligible entities receive information the NPDB has collected on medical malpractice payments and certain adverse actions. These payments and adverse actions are required to be reported to the NPDB under Title IV of Public Law 99-660, the Health Care Quality Improvement Act of 1986 (Title IV); Section 1921 of the Social Security Act (Section 1921); Section 1128E of the Social Security Act (Section 1128E); and their implementing regulations found at 45 CFR Part 60.

This chapter describes what entities are eligible to access the NPDB. It also describes what entities are required to or permitted to report to and query the NPDB. Finally, the chapter addresses how eligible entities register with the NPDB and how individuals and authorized agents can be empowered to query and report on behalf of eligible entities.

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