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Who Can Query and Report to the NPDB?

Title IV Requirements
Entity Query Report
Medical malpractice payers Prohibited Required
Hospitals Required* Required
Health care entities with formal peer review Optional Required
Professional societies with formal peer review Optional Required
Boards of Medical Examiners (State Medical and Dental Boards) Optional Required
Other State Licensing Boards Optional No Requirement
Drug Enforcement Administration Prohibited Required
HHS Office of Inspector General Prohibited Required
Section 1921 and Section 1128E Requirements
Entity Query Report
Hospitals* Optional** No Requirement
Health care entities with formal peer review Optional** No Requirement
Health plans Optional Required (1128E)
Professional societies with formal peer review Optional** No Requirement
Quality Improvement Organizations Optional** No Requirement
State Licensing and Certification Authorities Optional Required (1921)
Peer review organizations Prohibited Required (1921)
Private accreditation organizations Prohibited Required (1921)
State law enforcement agencies*** Optional Required (1921)
State Medicaid Fraud Control Units*** Optional Required (1921)
State agencies administering or supervising the administration of state health care programs*** Optional Required (1921)
Agencies administering Federal health care programs, including private entities administering such programs under contract Optional Required**** (1128E)
Federal licensing and certification agencies Optional Required**** (1128E)
Federal law enforcement officials and agencies Optional Required**** (1128E)

* Under Title IV, hospitals must query when physicians, dentists, and other health care practitioners apply for medical staff appointment (courtesy or otherwise) or for clinical privileges, and every two years on physicians, dentists, and other health care practitioners who are part of the medical staff or who hold privileges.

** These entities are not authorized to receive exclusions, criminal convictions, civil judgments, and other adjudicated actions or decisions that are reported under Section 1921.

*** The NPDB regulations define "state law or fraud enforcement agency" to include but not to be limited to these entities.

**** Section 1128E requires reporting by "Federal Government agencies," as specified in the regulations.