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NPDB Guide To Reporting Medical Malpractice Payments

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NPDB Guide To Reporting Medical Malpractice Payments

Before Submitting:

Are you an entity (including an insurer or self-insured organization) that has made a payment for the benefit of a health care practitioner in settlement of, or in satisfaction of, or in satisfaction in whole or in part of, a written claim or judgment against that health care practitioner?

Medical malpractice payments must meet A, B and C:

  • A: Must be an exchange of money
  • B: Must be the result of a written complaint or claim demanding monetary payment for damages (based on practitioner's provision of or failure to provide health care services)
  • C: The practitioner must be named or sufficiently described in both the complaint or claim, and the settlement release or final adjudication*

Submit a Medical Malpractice Report

Submit within 30 days of when the payment was made.

The NPDB notifies the subject of the report when the report is submitted.

Submit a Report: Do Not Submit a Report:
  • If the payment was made by an entity comprised of sole practitioner for the benefit of a name practitioner
  • If a practitioner fee was refunded as the result of a written request
  • If a business entity comprised of a sole practitioner settles a claim
  • If the dismissal of the practitioner was the result of a condition in the settlement or release
  • A payment based on a high-low agreement that was in place prior to a verdict or arbitration decision.
  • If the payment made by the individual practitioner out of personal funds (not a solo practitioner corporation)
  • If there was a waiver of debt where no money exchanged
  • If the settlement is made on behalf of a named business or corporate with multiple practitioners
  • The practitioner was dismissed from the claim or complaint prior to the settlement or final adjudication without condition or promise of payment
  • The fact finder ruled in favor of the defendant practitioner and assigned no liability

Report Modifications (when needed):

The NPDB notifies the subject of a report when a report is submitted and when any of these modifications are made.

  • Did your organization determine there is an error or omission in a previously submitted report? If yes, submit a Correction Report.
  • Did your organization determine that an action should not have been reported because:
    • The report was erroneously submitted?
    • The action is not reportable?
    • The action was revered or overturned?
    These are the only reasons for which a report may be voided.

* The practitioner must be named, identified, or otherwise described in both the written complaint or claim demanding monetary payment for damages and the settlement release or final adjudication.

This image is a greyscale version of the NPDB Guide to Reporting MMPR