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Data Bank Guide for Reporting Medical Malpractice Payments to the NPDB

Text-only version of chart. (PDF - 177 KB)

This chart represents a summary of NPDB reporting guidance.

  • 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 in whole or in part of, a written claim or judgment against that health care practitioner?
    • If Yes, medical malpractice payments must meet the following criteria:
      1. Must be the exchanges of money;
      2. Must be the result of a written complaint or claim demanding monetary payment for damages (based on the practitioner's provision of or failure to provide health care services);
        AND
      3. The practitioner must be named in both the complaint or claim, and the settlement release or final adjudication.

      If the above criteria apply to your reporting scenario, submit an Initial Report.
    • If No, then you may not be required to submit a Medical Malpractice Payment Report to the Data Bank.
  • Did your organization determine that there is an error or omission in a previously submitted report?
    • If Yes, submit a Correction Report.
    • If No, then you may not be required to submit a Medical Malpractice Payment Report to the Data Bank.

Common MMPR Reporting Clarifications: The following are common MMPR reporting scenarios.

  • Was the payment made by a professional corporation or other business entity comprised of a sole practitioner for the benefit of a named practitioner?
    • If Yes, submit an Initial Report.
    • If No, was the payment made by the individual practitioner out of personal funds?
      • If Yes, then DO NOT submit a report.
      • If No, then go to the next question.
  • Was a practitioner fee refunded and was the refund made by an entity, including a solo incorporated practitioner?
    • If Yes, submit an Initial Report.
    • If No, was the refund made out of the practitioner's personal funds?
      • If Yes, DO NOT submit a report.
      • If No, go to the next question.
  • Was a payment made by an entity solely for the benefit of a corporation?
    • If Yes, was the corporation a business entity comprised of a sole practitioner?
      • If Yes, submit an Initial Report.
      • If No, then DO NOT submit a report.
    • If No, then go to the next question.
  • Was the practitioner dismissed from the claim or complaint prior to settlement or final adjudication?
    • If Yes, was the dismissal the result of a condition in the settlement or release?
      • If Yes, submit an Initial Report.
      • If No, DO NOT submit a report.
    • If No, then go to the next question.
  • Was a payment made based on a high-low agreement that was in place prior to a verdict or arbitration decision?
    • If Yes, does the payment meet the following criteria?
      1. The payment was made at the low end of the high-low agreement
        AND
      2. The fact finder ruled in favor of the defendant practitioner and assigned no liability.
      • If Yes, DO NOT submit a report.
      • If No, submit an Initial Report.
    • If No, then go to the next question.
  • Were loss adjustment expenses (i.e., expenses other than those in compensation of injuries, such as expert witness fees) included in the medical malpractice payment amount? Payments made exclusively for loss adjustment expenses are not reportable.
    • If Yes, submit an Initial Report and report the loss adjustment expenses as part of the total amount of the medical malpractice payment.
    • If No, if a report is submitted, do not report the loss adjustment expenses.

Note: Reports must be submitted to the NPDB within 30 days of the date the payment was made, and a copy of the report must be sent to the appropriate State Licensing Board.