National Practitioner Data Bank -- Interactive Training Program

Medical malpractice payers, State licensing boards, hospitals, other health care entities, and professional societies are responsible for reporting to the NPDB medical malpractice payments made and adverse actions taken on or after
September 1, 1990. The Office of the Inspector General (OIG), Health and Human Services (HHS), reports Medicare/Medicaid exclusions from May of 1979 to the present. The information required to be reported to the NPDB is applicable to physicians, dentists, and, in some cases, other health care practitioners who are licensed or otherwise authorized by a State to provide health care services.

There are three ways of submitting reports to the NPDB:

Interactively via the Internet using the Integrated Querying and Reporting Service (IQRS).
Using an Extensible Markup Language (XML) transaction file submission program, the Querying and Reporting XML Service (QRXS).
Using a proprietary transaction file submission program, the ICD Transfer Program (ITP).

Medical malpractice payers and State Licensing Boards must submit reports within 30 calendar days of the date of a payment or adverse licensure action. Hospitals, other health care entities, and professional societies must submit reports within 15 calendar days of the date of an adverse action. Hospitals, health care entities, professional societies and medical malpractice payers must print a copy of each report submitted to the NPDB and mail it to the appropriate State licensing board for its use.

The purpose of the narrative description section of the report is to describe the acts or omissions or reasons for the action reported, as required by Section 423(a)(3)(B) of the Health Care Quality Improvement Act [42 U.S.C., Section 11133(a)(3)(B)]. This means that a reporting entity must provide narrative descriptions with sufficient specificity to enable a knowledgeable observer to determine clearly the circumstances of the action or surrender.

The Initial Report is the first record of a medical malpractice payment or adverse action submitted to and processed by the NPDB.

When an Initial Report is submitted via the IQRS, a Report Verification Document is stored on the IQRS for retrieval by the reporting entity. When an Initial Report is submitted via the ITP or QRXS, the Report Verification Document is transferred electronically back to the reporting entity using ITP or QRXS. In all cases, a Notification of a Report in the Data Bank(s) is mailed to the subject of the report. The reporting entity should also print and mail a copy of the Initial Report to the appropriate State licensing board.

An Initial Report is considered the current version of the report until a Correction, Void, or Revision to Action is submitted.

Click on the type of report that you would like to learn more about:

• Correction
• Void
• Revision to Action

Reports submitted to the NPDB are normally processed within two to four hours. Under certain circumstances, additional processing may be required.

Please do not re-submit your report on the subject in question, since this will result in duplicate transactions. If you do not receive your Report Verification Document within 2-3 business days of submission, contact the Customer Service Center.

Medical malpractice payers that fail to report medical malpractice payments in accordance with NPDB legislation will be subject to civil fines of up to $11,000 for each payment not reported.

If the U.S. Department of Health and Human Services determines that a health care entity or a professional society has substantially failed to report information in accordance with NPDB legislation, the name of the entity will be published in the Federal Register, and the entity will lose the immunity provisions 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 medical and dental boards that fail to comply with NPDB reporting requirements can have the responsibility to report removed from them by the Secretary of HHS. In such instances, the Secretary will designate another qualified entity to report NPDB information.

Correction/Void/Revision to Action Flow Chart