Exhibit 1

Exhibit 1.docx

Survey of Eligible Users of the National Practitioner Databank

Exhibit 1

OMB: 0915-0366

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Exhibit 1. Who Can Query and Report to the NPDB?

Entity

Query

Report

Title IV

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

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.


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