Attachment 1 Overview of the NPDB

Attachment 1 Overview of the NPDB.docx

Survey of Eligible Users of the National Practitioner Databank

Attachment 1 Overview of the NPDB

OMB: 0915-0366

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Table A. Overview of the NPDB

Reporters

  • Medical Malpractice Payers

  • Medical/Dental State Licensing Boards

  • Hospitals and Other Healthcare Entities

  • Professional Societies with formal peer review

  • DHHS Office of Inspector General

  • U.S. Drug Enforcement Administration

  • Federal and State Government agencies

  • Health plans



Queriers

  • Hospitals

  • Professional Societies with formal peer review

  • Boards of Medical/Dental Examiners and other healthcare practitioner State Licensing Boards

  • Other healthcare entities with formal peer review

  • Plaintiffs’ attorneys or plaintiffs representing themselves (limited)

  • Healthcare practitioners and practitioner organizations (self-query)

  • Researchers (statistical data only)

  • Federal and State Government agencies

  • Health plans

  • Healthcare practitioners/providers/suppliers (self-query)

  • Researchers (statistical data only)

Available Information

  • Medical malpractice payments (all healthcare practitioners)

  • Adverse actions - based on reasons relating to professional competency and conduct (primarily physicians/dentists)

  • Licensing actions: revocation, suspension, censure, reprimand, probation, surrender, denial of an application for renewal of license, and withdrawal of an application for renewal of license (reported as a voluntary surrender)

  • Clinical privileges actions

  • Professional society membership actions

  • Medicare and Medicaid exclusions (all healthcare practitioners)

  • U.S. Drug Enforcement Administration actions (all healthcare practitioners)

  • Licensing and certification actions

    • Revocation, suspension, censure, reprimand, probation

    • Any other loss of license – or right to apply for or renew – a license of the provider, supplier, or practitioner, whether by voluntary surrender, non-renewal, or otherwise

    • Any negative action or finding by a Federal or State licensing and certification agency that is publicly available information

    • Civil judgments (healthcare-related)

    • Criminal convictions (healthcare-related)

    • Exclusions from Federal or State healthcare programs

    • Other adjudicated actions or decisions



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