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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 Organization Negative Actions or Findings Reporting Exclusions from Participation in Federal or 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

Q&A: Reporting Civil Judgments

  1. The DOJ pursued a civil False Claims Act case against a physician for billing for services that were not provided as claimed. The physician agreed to pay $35,000 to settle False Claims Act liability. The OIG participated in the settlement and waived its exclusion authority in exchange for an integrity agreement with the physician. In the settlement, the physician neither admitted nor denied liability. Should anything be reported to the NPDB?

    No. Settlements in which no findings or admissions of liability have been made are not reportable to the NPDB. Because the physician agreed to a payment as part of a settlement, without admitting liability, the DOJ should not report this settlement and payment. In addition, the OIG should not report either its waiver of its exclusion authority or the integrity agreement. The waiver of exclusion authority is not required to be reported, and the integrity agreement is part of the settlement in which no findings or admissions of liability were made.

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