Report to the Data Banks
Information that is applicable to practitioners, providers, or
suppliers who are licensed or otherwise authorized by a State to
provide health care services must be reported to the NPDB, the HIPDB,
or both. Eligible entities are responsible for meeting specific
reporting requirements and must register in order to submit reports.
Medical Malpractice Payment Reports
Medical malpractice payers must submit reports to the NPDB and
to the appropriate State licensing board within 30 days of
a payment. The HHS Office of Inspector General (OIG) has the authority
to impose civil money penalties in accordance with Sections 421(c)
and 427(b) of Title IV if these reporting requirements are not met.
Under the statute, any malpractice payer that fails to report medical
malpractice payments in accordance with Section 421(c) is subject
to a civil money penalty of up to $11,000 for each such payment
involved.
A Draft Medical Malpractice Payment Report form in Microsoft Word format is available. The MMPR form is modeled after the IQRS MMPR Input Form. Users can use the form to gather MMPR data required by the IQRS. For additional information, see the Draft Medical Malpractice Payment Report form (MS Word).
Adverse Action Reports
Hospitals and Other Health Care Entities
Health care entities must report adverse actions within 15 days
from the date the adverse action was taken or clinical privileges
were voluntarily surrendered. Reporters must provide factually sufficient narrative descriptions in reports to meet the statutory reporting requirements. For additional information, read the Fact
Sheet on Submitting a Factually Sufficient Narrative Description  . The health care entity must print
a copy of each report submitted to the NPDB and mail it to the appropriate
State licensing board for its use. The Report Verification Document
that health care entities receive after the report is successfully
processed by the NPDB should be used for submission to the appropriate
State licensing board. If the Secretary of HHS determines that a
health care entity has failed substantially to report information
in accordance with Title IV requirements, the name of the entity
will be published in the Federal Register, and the entity will lose
its immunity from liability under Title IV with respect to
professional review activities for a period of 3 years, commencing
30 days from the date of publication in the Federal Register.
State Licensing Boards
State Medical and Dental Boards must submit reports to the NPDB
within 30 days from the date the adverse action was taken. Reporters must provide factually sufficient narrative descriptions in reports to meet the statutory reporting requirements. For additional information, read the Fact
Sheet on Submitting a Factually Sufficient Narrative Description . State Medical and Dental Boards that fail to comply with NPDB reporting
requirements can have the responsibility to report removed by the
Secretary of HHS. In such instances, the Secretary will designate
another qualified entity to report NPDB information.
Professional Societies
Professional societies must report adverse actions within 15 days
from the date the adverse action was taken. Reporters must provide factually sufficient narrative descriptions in reports to meet the statutory reporting requirements. For additional information, read the Fact
Sheet on Submitting a Factually Sufficient Narrative Description . The professional society
must print a copy of each report submitted to the NPDB and mail
it to the appropriate State licensing board for its use. The Report
Verification Document that professional societies receive after
the report is successfully processed by the NPDB should be used
for submission to the appropriate State licensing board. A professional
society that has substantially failed to report adverse membership
actions taken against physicians and dentists based on professional
competence and conduct can lose the immunity protections provided
under Title IV for 3 years.
Judgment Or Conviction Reports
Health care-related civil judgments and criminal convictions that
must be reported to the HIPDB include: criminal convictions, civil
judgments, injunctions, and nolo contendere/no contest pleas related
to health care.
For more details on reporting, refer to the Fact
Sheet on Reporting , the NPDB Guidebook,
and the HIPDB Guidebook.
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