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

    Yes. The exclusion of health care practitioners, providers, or suppliers from participation in Federal or State health care programs must be reported to the NPDB. However, exclusions are distinct from licensure and certification actions and should be reported to the NPDB as Exclusion or Debarment actions on the Adverse Action Report format. For more information, see the section in this chapter on Reporting Exclusions from Participation in Federal or State Health Care Programs.

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