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Guidebook Cover Page

Table of Tables

Table of Figures

Chapter A: Introduction and General Information

Chapter B: Eligible Entities

Chapter C: Subjects of Reports

Chapter D: Queries

Chapter E: Reports

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

Chapter F: Subject Statements and the Dispute Process

Chapter G: Fees

Chapter H: Information Sources

Appendix A: Glossary

Appendix B: Acronym Guide

Appendix C: Change History

Download the NPDB Guidebook (PDF - 2.13 MB)

Q&A: Reporting Medical Malpractice Payments

  1. The authorized submitter for a medical malpractice payer found documentation of reportable payments that were not reported to the NPDB. What should the authorized submitter do?

  2. Do medical malpractice payers have to report payments made for the benefit of a deceased practitioner?

  3. How should a payment be reported to the NPDB if a total amount has not been determined and the payer is making an initial partial payment?

  4. Should a payment exclusively for the benefit of a clinic, hospital, or other health care entity be reported?

  5. What are the NPDB reporting requirements for self-insured employers who provide professional liability coverage for their employed health care practitioners?

  6. If a patient makes an oral demand for payment for damages, should the resulting payment be reported to the NPDB?

  7. A patient's mother, who has no legal authority over the patient, files a written claim against a health care practitioner, demanding payment based on the practitioner's services to the patient. A medical malpractice payer organization pays the patient's mother the amount the mother demands. Should the payment be reported to the NPDB as a medical malpractice payment?

  8. A patient made a written demand for a refund for services and, in response, the practitioner made the payment out of her personal funds. Should the payment be reported to the NPDB?

  9. Following an unsuccessful course of treatment, a patient and a practitioner enter into a state-sponsored voluntary series of discussions in an attempt to settle their disagreement before resorting to litigation. The discussions lead to the practitioner's insurance company making a money payment to the patient to settle the dispute. Should this money payment be reported to the NPDB?

  10. If an individual practitioner is not named, identified, or described in a medical malpractice claim or complaint, but the facility or practitioner group is named, should the payment be reported?

  11. Should a medical malpractice payment be reported to the NPDB on behalf of a health care practitioner who owns an SSC if the payment is made on behalf of the SSC alone and the claim was based solely on the acts of the SSC's staff, not the acts of the SSC's owner?

  12. A supervisory practitioner is named in an action based on the services of a subordinate practitioner, and payments are made for the benefit of the supervisor and the subordinate. How should the payments be reported to the NPDB?

  13. If a stipulation of settlement or court order requires that terms remain confidential, how does a medical malpractice insurer report the payment to the NPDB without violating the settlement agreement or court order?

  14. If there is no medical malpractice payment and Loss Adjustment Expenses (LAEs) are paid in order to release or dismiss a health care practitioner from a medical malpractice lawsuit, should the LAEs be reported?

  15. Does a medical malpractice payment have to exceed a certain dollar amount before it is reportable to the NPDB?

  16. A defendant health care practitioner agreed to settle 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?

  17. A hospital and a health care practitioner were named in a medical malpractice claim. Further review revealed that the practitioner had never treated the plaintiff who filed the claim. The practitioner was dismissed from the lawsuit without condition. A settlement on behalf of the hospital was reached and a payment was made to the plaintiff to resolve the claim. The release stated that the defendant health care practitioner was dismissed from the lawsuit prior to settlement and the payment was being made on behalf of the hospital. Is this payment reportable to the NPDB?


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