The National Practitioner Data Bank and its Effects on Practitioners

Published on by Melissa

The National Practitioner Data Bank (NPDB) is a database operated by the U.S. Department of Health and Human Services that contains medical malpractice payment and adverse action reports on health care professionals.

A negative NPDB report can have serious consequences for a physician. As a result of information contained in the NPDB, a healthcare practitioner may find their employment opportunities diminished and ability to obtain professional liability insurance hindered. Thus, it is imperative that healthcare practitioners understand who can report, what is reportable to the NPDB, who has access to the report, and any recourse once a report is posted on the NPDB website.  

Only registered entities have access to the reports and interact with the NPDB, including the following: hospitals, health plans, state licensing boards, medical malpractice payers, and other health care entities.  Individual practitioners may access reports about themselves.

Reports are permanently stored in the NPDB unless modified or removed by the organization that submitted the report. Below is a list of what must be reported:

  • Medical malpractice payments
  • Federal and state licensure and certification actions
  • Adverse clinical privileges actions
  • Adverse professional society membership actions
  • Negative actions or findings by private accreditation organizations and peer review organizations
  • Healthcare-related criminal convictions and civil judgments
  • Exclusions from participation in a Federal or state healthcare program (including Medicare and Medicaid exclusions)
  • Other adjudicated actions or decisions

For additional information regarding NPDB reports, or for assistance with any NPDB repercussions or incorrect reports, please do not hesitate to reach out to us at Crick Walanka Law Group.

Disclaimer: This web site is addressed to those who hold professional licenses issued by the Illinois Department of Financial and Professional Regulation and by similar licensing agencies in other states. Suggestions herein are, in most circumstances, valid for any type investigation, whether administrative, criminal, or civil. However, it should be noted that in some other states, one who holds a professional license may be required to submit to an investigative interview as a condition of being licensed. Whatever the circumstances, a licensed professional who becomes the subject of an investigation would be wise to immediately retain legal counsel. No content, whole or in part, is to be considered as “legal advice,” and by reading this document, no attorney-client relationship is formed with the Crick Walanka Law Group, Ltd.
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