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Chapter 2: National Practitioner Data Bank Statutes and Regulations

Health Care Quality Improvement Act

Title IV of Public Law 99-660 (42 USC § 11101 et seq.), the Health Care Quality Improvement Act of 1986 (HCQIA), created the NPDB. Issues that led to the adoption of HCQIA included:

  • An increasing occurrence of medical malpractice and the need to improve the quality of medical care;
  • A need to restrict the ability of incompetent physicians to move from State to State without disclosure or discovery of the physician's previous damaging or incompetent performance
  • A need for effective professional peer review to protect the public;
  • The threat of private monetary damages liability discouraging physicians from participating in effective professional peer review; and
  • The need to provide incentives and protection for physicians engaging in effective professional peer review.

The NPDB, implemented in 1990, serves as an electronic repository to collect and release information related to the professional competence and conduct of physicians, dentists, and, in some cases, other health care practitioners. The NPDB is primarily an alert or flagging system intended to facilitate a comprehensive review of health care practitioners' professional credentials. The information contained in the NPDB is intended to direct discrete inquiry into, and scrutiny of, a practitioner's licensure, clinical privileges, professional society memberships, and medical malpractice payment history.