Health Care Law Blog

National Practitioner Data Bank

Hospitals are required to report certain adverse clinical privileging actions and medical malpractice payments to the National Practitioner Data Bank (NPDB).  Since the NPDB was established by the Health Care Quality Improvement Act (HCQIA) in 1986, compliance with these reporting obligations has been largely entrusted to hospitals with little enforcement action by the United States Department of Health and Human Services.  There are now reports that the federal government has begun auditing compliance by hospitals with the NPDB reporting requirements.

The HCQIA provides sanctions that can be imposed for failure to make required reports, including civil monetary penalties and loss of immunity for professional review activities. It remains uncertain whether HHS will seek sanctions as part of its enforcement push. Hospitals should be prepared for such potential audits. A review of the procedures and policies for reporting privileging actions and medical malpractice payments would be prudent.

If you have any questions, please contact Richard C. Kraus or Gary J. McRay by using the form below.

Categories: Audits, Compliance, Hospitals, Physicians

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