Attachment 7 Who can query

OMB Number: 0915-0366; Expiration date: XX/XX/202X

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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