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Chapter 4: Reporting and Querying

Reporting to the NPDB

The statutes and regulations governing the information and types of entities (Table 2) that are required to submit reports to the NPDB were described in Chapter 1.

Table 2: Entities that Report to the NPDB

Entity Report
State Medical and Dental Boards Required to report on licensure disciplinary actions, e.g., revocation, suspension, voluntary surrender while under investigation, license restriction, and any negative
State Licensing Boards for Other Health Care Practitioners Required to report in generally the same manner as State medical and dental boards.
Hospitals Required to report on adverse professional review actions related to professional competence or conduct that impact physician or dentist privileges or panel memberships for more than 30 days. Required to report a physician's or dentist's voluntary surrender or restriction of clinical privileges or panel memberships while being investigated for possible professional incompetence or improper professional conduct or in return for an entity not conducting an investigation or taking a reportable professional review action.
Health Care Entities* Required to report in the same manner as hospitals.
Professional Societies that Follow a Formal Peer Review Process Required to report on adverse professional review actions based on reasons related to professional competence or professional conduct that adversely affects a physician's or a dentist's membership.
Medical Malpractice Payers Required to report all medical malpractice payments when an entity makes a payment for the benefit of a health care practitioner in settlement or in satisfaction, in whole or in part, of a claim or judgment against that practitioner.
Peer Review Organizations Required to report recommendations to sanction a health care practitioner.
Private Accreditation Organizations Required to report certain final actions taken by the private accreditation organization against a health care entity that is licensed or otherwise authorized by a State to provide health care services.
State Agencies that License Health Care Entities Required to report in the same manner as State medical and dental boards.

*Health care entities or organizations must provide health care services, directly or indirectly, and follow a formal peer review process for the purpose of furthering quality health care.