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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

Q&A: Reporting State Licensure and
Certification Actions

  1. How should a State licensing or certification authority report actions when they are changed by court order?

  2. How should a negative finding in a State nurse aide registry be reported to the NPDB?

  3. When reporting a reprimand by a State licensing board, what Length of Action should the board enter in the report?

  4. Should a State licensing or certification authority report a suspension when the suspension has been fully stayed prior to implementation?

  5. If, as a result of a formal proceeding, a State licensing board suspends a practitioner's license for 1 year, but stays 3 months of the suspension, how should it be reported?

  6. A State licensing board submitted a report to the NPDB 6 months ago, after the board placed a practitioner's license on probation. Three months ago, the board reinstated the license in full. The report in the NPDB still indicates that the license is on probation. Because the status of the licensure action has changed, should the board update the information in the NPDB?

  7. A board of medical examiners initiated an investigation related to a physician's professional conduct. Two weeks later, the physician allowed his license to expire. Since the physician's license lapsed prior to any proposed agreement or board decision, must the lapse be reported to the NPDB?

  8. How should an action taken against a nurse who is licensed in one State but authorized to practice in another State under the Nurse Licensure Compact (NLC) be reported to the NPDB?

  9. A State licensing board issued a formal cease and desist order to an unlicensed practitioner who held herself out to be a licensed psychotherapist. Should the action be reported to the NPDB?

  10. A State Medicaid agency terminated the contract for participation of one of its Medicaid MCOs after holding formal hearings and determining that the MCO had not maintained a sufficient network of providers to meet the State's access and quality requirements. Should the State agency report this action to the NPDB?

  11. A State Medicaid agency excluded a pharmacy from the State's Medicaid program for submitting false claims. Is this action reportable?

  12. A physician voluntarily terminated a contract to participate in a State health care program after the State initiated an investigation into allegations that the physician had billed for services not provided. Should this action be reported to the NPDB?

  13. If a State licensing or certification authority takes an action that is later expunged, should the State licensing or certification authority report the expungement?

  14. A State medical board suspended a physician's license and, as a result of the same incident, the State pharmacy board revoked the Controlled Dangerous Substance (CDS) registrations of both the physician and a pharmacy that filled many of the physician's prescriptions. All actions were taken as a result of formal proceedings. How should these actions be reported to the NPDB?

  15. If a State licensing or certification authority issues a letter of concern, should it be reported to the NPDB?

  16. As a result of a formal proceeding, a State licensing or certification authority reprimanded a practitioner. In addition, the authority imposed a publicly available, technical, administrative fine, which is not an adverse action, in the amount of $500. Should this administrative fine be reported to the NPDB?

  17. A State licensing board is required to report any publicly available negative actions or findings. If a State licensing board does not publish its actions on the board's website, but publishes them in a publicly available monthly newsletter, does the board still have to report the actions to the NPDB?

  18. During an interview with a practitioner, a State licensing board discovers that the practitioner failed to disclose prior substance abuse on a licensure application. As a result, the State board required the practitioner to complete 5 hours of continuing education pertaining to professional ethics. Should this action be reported to the NPDB?

  19. When should administrative fines be reported to the NPDB?

  20. If, as a result of a formal proceeding, a State dental board suspends a dentist's permit to administer anesthesia, should the action be reported to the NPDB?

  21. If a State board denies an application to a practitioner who did not have the required number of practicum hours, should the action be reported?

  22. A State agency responsible for licensing skilled nursing facilities suspended a facility's license after substantiating several serious quality of care complaints against the facility. Is this reportable to the NPDB?

  23. A State licensing and certification authority suspended the license of a durable medical equipment supplier for selling defective intravenous supplies. Is this reportable to the NPDB?

Do you have a question about the NPDB Guidebook that you'd like answered?