• Subject Requests Correction
• Subject Adds Statement
• Subject Initiates Dispute
• Subject Requests Secretarial Review
• Report Accurate as Submitted and/or Action or Payment Reportable
• Report Inaccurate as Submitted and/or Action or Payment Not Reportable
• Issues in Dispute Outside Secretarial Review
When the NPDB processes a report, a Notification of a Report in the Data Banks(s) is mailed to the subject. The subject should review the report for accuracy, including such information as current address and place of employment. If any information in a report is inaccurate, the subject must request that the reporting entity file a Correction to the report.
If the reporting entity declines to change the report, the subject may initiate a dispute of the report through the dispute process, add a statement to the report, or both.
Subject Adds Statement:The subject of a NPDB report may add a statement to the report at any time through the on-line Report Response Service. Subject Statements are limited to 4,000 characters, including spaces and punctuation, and cannot include patient names or the names of any other individuals.
When the NPDB processes a statement, notification of the statement is sent to all queriers who received the report within the past three years and will also be included with the report when it is released in the future.
A statement is part of the specific report for which it
is filed. If the reporting entity changes the report, the statement attached
to the report will stay with the report. If the subject wants the statement
removed from the new report, the subject must remove the statement.
The subject of an Adverse Action Report or a Medical Malpractice Payment Report may dispute either the factual accuracy of the report or whether a report was submitted in accordance with the NPDB's reporting requirements, including the eligibility of the entity to report the information to the NPDB. Disputes must be initiated through the on-line Report Response Service. A subject may not dispute a report in order to protest a decision made by an insurer to settle a claim or to appeal the underlying reasons for an adverse action.
If a subject believes that information in a report is factually inaccurate or should not have been reported, the subject must attempt to resolve the disagreement directly with the reporting entity. Changes to a report may be submitted only by the reporting entity.
When the NPDB processes a dispute, notification of the dispute is sent to all queriers who received the report in the past three years, and will also be included with the report whenever it is disclosed in the future.
A dispute becomes part of the specific report it is
contesting. If the report is changed by the reporting entity, the dispute notation
attached to the report stays. The subject may withdraw the dispute at any time.
If the reporting entity declines to change the disputed Adverse Action Report or Medical Malpractice Payment Report or takes no action, the subject may request that the Secretary of HHS review the disputed report.
To request Secretarial Review of a disputed report, the subject must do so on-line, through the Report Response Service. Please note that any accompanying documentation must be sent to the NPDB, not directly to the Secretary of HHS. The subject also must:
State clearly and briefly in writing which facts are in dispute and what the subject believes are the facts.
Submit documentation substantiating that the reporting entity's information is inaccurate. Documentation must directly relate to the facts in dispute and substantially contribute to the determination of the factual accuracy of the report. Documentation may not exceed 10 pages, including attachments and exhibits. More documentation will be requested if it is necessary for proper resolution of the matter.
Submit proof that the subject attempted to resolve the dispute with the reporting entity but was unsuccessful. Proof may be a copy of the subject's correspondence to the reporting entity and the entity's response, if any.
The Secretary reviews disputed reports only for accuracy of factual information and to ensure that the adverse action or medical malpractice payment is reportable. The Secretary does not review the merits of a medical malpractice claim in the case of a payment or the appropriateness of, or basis for, a health care entity's professional review action or a State licensing board's action.
The subject should wait for 30 days from the date of initiating discussions with the reporting entity before requesting Secretarial Review to give the reporting entity time to respond to the dispute.
The dispute and any accompanying documentation must
be sent to the NPDB, not directly to the Secretary.
If the Secretary concludes that the information in the report is accurate and/or the adverse action or medical malpractice payment is reportable, the Secretary sends an explanation of the decision to the subject. The subject may then submit a statement that is added to the report. The statement is limited to 4,000 characters, including spaces and punctuation, and is entered into the NPDB computer system exactly as submitted. The new Subject Statement replaces any statement the subject submitted previously.
The subject of the report, the reporting entity, and all
queriers who received notice of the disputed report are each sent a Report
Revised, Voided, or Status Changed document containing the Secretary's explanation
and the subject's statement. Future queriers will receive the Secretary's and
subject's statements with the report.
If the Secretary concludes that the report is inaccurate and/or the medical malpractice payment or adverse action is not reportable, the Secretary directs the NPDB to correct the information in the report.
If the Secretary concludes that the report was submitted in error, the Secretary directs that the report be voided from the NPDB.
The subject of the report, the reporting entity, and
all queriers who have received notice of the disputed report are each sent a
Report Revised, Voided, or Status Changed document informing them that
the report has either been corrected or voided.
If the Secretary concludes that the issue in dispute is outside the scope of review, the Secretary will direct the NPDB to add an entry to that effect to the report and to remove the dispute notation. The subject may then submit a statement that will be added to the report. The statement is limited to 4,000 characters, including spaces and punctuation, and will replace any statement the subject submitted previously. If no new subject statement is received, any existing statement previously submitted by the subject is maintained as part of the report record.
The subject of the report, the reporting entity, and all entities who received notice of the disputed report within the past three years will receive a Report Revised, Voided, or Status Changed document informing them of the Secretary's decision.