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Is It Reportable?

A health plan terminated contracts with several psychologists in its network because the plan determined it already had too many psychologists in that geographic area. Should this action be reported??

Featured in the September 2018 NPDB Insights

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Is It Reportable? Archive

A defendant health care practitioner settled a medical malpractice claim in exchange for being dismissed from a lawsuit. All parties involved in the lawsuit agreed to the condition. Should the resulting payment be reported to the NPDB?
Featured in the August 2018 NPDB Insights

A hospital automatically revoked a physician's clinical privileges when the physician lost her license. Should this action be reported?
Featured in the July 2018 NPDB Insights

Are medical malpractice payers required to report payments made for the benefit of a deceased practitioner?
Featured in the June 2018 NPDB Insights

If a state board denies the application of a practitioner who did not have the required number of practicum hours, should the action be reported?
Featured in the May 2018 NPDB Insights

A physician is being investigated by a hospital for issues related to professional competence and resigns her clinical privileges. At the time of her resignation, she states that she plans to move to a different state. Should the resignation be reported to the NPDB?
Featured in the April 2018 NPDB Insights

After receiving multiple "quality of care" complaints about a physician, a hospital initiated an investigation. During the investigation, the physician resigned her clinical privileges at the hospital. Since there was no professional review action taken, should a report be submitted to the NPDB?
Featured in the March 2018 NPDB Insights

Do medical malpractice payers have to report payments made for the benefit of a deceased practitioner?
Featured in the February 2018 NPDB Insights

A hospital initiated an investigation related to the professional conduct of a physician who held time-limited, nonrenewable, temporary privileges at the hospital. During the investigation, the physician's temporary privileges expired and the hospital took no further action. Should this be reported?
Featured in the January 2018 NPDB Insights

A hospital repeatedly reminded a physician to update his medical records in a timely manner. After there was no change in the physician's behavior, the hospital initiated an investigation, which revealed that the physician had more than 300 incomplete medical records. As a result, the hospital took a professional review action to suspend the physician's clinical privileges for 60 days, citing professional misconduct. Because there was no actual patient harm, should this be reported to the NPDB?
Featured in the December 2017 NPDB Insights

If an "impaired practitioner" takes a leave of absence and enters a rehabilitation program, must it be reported?
Featured in the November 2017 NPDB Insights

A hospital summarily suspended a physician's clinical privileges to allow sufficient time for allegations of gross negligence to be fully investigated. The day after the summary suspension was imposed, the physician requested an educational leave of absence. If the hospital grants the leave of absence, must the summary suspension be reported to the NPDB?
Featured in the October 2017 NPDB Insights

A hospital suspended a physician's clinical privileges for 45 days for failing to complete medical records. Should this action be reported to the NPDB?
Featured in the September 2017 NPDB Insights

Must a hospital or other health care entity report adverse actions concerning the clinical privileges of medical and dental residents and interns?
Featured in the August 2017 NPDB Insights

A health care entity (an HMO) terminated a physician's contract for causes relating to poor patient care, which in turn resulted in the loss of the practitioner's network participation. Should this be reported to the NPDB using one or two reports?
Featured in the July 2017 NPDB Insights

A physician applying for renewal of his hospital clinical privileges falsified his application by omitting information about an ongoing licensure investigation. The hospital took a professional review action to deny his renewal application, which the MEC considered to be related to the practitioner's professional conduct, even though there was no actual patient harm. Should this be reported to the NPDB?
Featured in the June 2017 NPDB Insights

A preferred provider organization (PPO) investigated a member physician after receiving quality of care complaints from several plan participants. The physician was unaware of the investigation, but during the investigation, he relinquished his panel membership for personal reasons. Is this reportable?
Featured in the May 2017 NPDB Insights

A hospital filed a report with the NPDB announcing the revocation of a practitioner's clinical privileges. The reporting hospital had established a system of professional review under its bylaws, and it also had an employment termination procedure. In this case, the hospital used the employment termination procedure, not the professional review process. The practitioner's privileges were revoked by the employment termination process, but no action was taken through the professional review process. The practitioner was not given a choice of which process (system of professional review or employment termination procedure) the hospital would use. Should the hospital have filed the report with the NPDB?
Featured in the April 2017 NPDB Insights

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?
Featured in the March 2017 NPDB Insights

Should a medical malpractice payment made exclusively for the benefit of a clinic, hospital, or other health care entity be reported?
Featured in the January 2017 NPDB Insights

A physician applying for renewal of his hospital clinical privileges falsified his application by omitting information about an ongoing licensure investigation. The hospital took a professional review action to deny his renewal application, which the medical executive committee considered to be related to the practitioner's professional conduct, even though there was no actual patient harm. Should this be reported to the NPDB?
December 2016 NPDB Insights

If a state board that regulates dietitians issues a cease and desist order against a person who is not a registered dietitian but who is practicing as one, is the issuance of the cease and desist order reportable to the NPDB?
November 2016 NPDB Insights

If a physician's initial application for clinical privileges is denied or the privileges granted are more limited than those requested, must this be reported to the NPDB?
October 2016 NPDB Insights

A physician applied to a hospital for clinical privileges to perform cardiac procedures. The hospital requires that such applications be granted only if the applying physician has performed 50 cardiac procedures in the previous year. The applying physician has performed only 40 such procedures. The hospital denies the application based solely on the physician not having met its 50-procedure requirement. Should this denial be reported to the NPDB?
September 2016 NPDB Insights

A hospital's chief of surgery summarily suspended a physician's privileges for outbursts of anger and throwing charts and instruments in an operating room. Should this action be reported to the NPDB?
August 2016 NPDB Insights

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?
July 2016 NPDB Insights

A practitioner is meeting with the state's licensing or certification authority to discuss options for entering into an impaired practitioner program. The practitioner receives a recommendation to enter into the program. Should the licensing or certification authority report the practitioner's entering into the program to the NPDB?
June 2016 NPDB Insights

A court rules to settle a medical malpractice claim for expenses only. The defendant is released from the claim and the malpractice payer settles with the plaintiff's attorney for the amount of fees and expenses incurred by the plaintiff. Is this type of payment reportable to the NPDB?
May 2016 NPDB Insights

A surgeon is summarily suspended by the Chief of Staff for an outburst in the OR. An emergency meeting of the Medical Executive Committee (MEC) is convened to address the suspension. On advice of counsel, the MEC postpones the meeting until all of the individuals involved in the incident can be present for questioning. The MEC knows that this process will take longer than 30 days on the outset. Should they wait until the final outcome before they submit a report to the NPDB?
April 2016 NPDB Insights

A patient complains to her practitioner about an adverse reaction from an injection she received, and the practitioner offers the patient a refund for the office and injection fees. Is this refund reportable to the NPDB?
March 2016 NPDB Insights

Withdrawal of an Initial Application for Medical Staff Appointment
January 2016 NPDB Insights

A practitioner withdrew their initial application for a license with a state board. Is it reportable?
October 2015 NPDB Insights


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