National Practitioner Database

Advanced, Generic Clinical Sciences, Special Problems or Issues in Anesthesiology

The National Practitioner Database (NPDB) is an electronic repository of all payments made on behalf of physicians in connection with medical liability settlements or judgments as well as adverse peer review actions against licenses, clinical privileges, and professional society memberships of physicians and other health care practitioners. According to federal law, information on all medical liability payments and on certain adverse actions must be reported to the NPDB. In turn, the NPDB is required to make this information available to hospitals, state licensure boards, some professional societies, and other health care entities under certain circumstances. NPDB reporting requirements The NPDB collects and disseminates certain information, including:

  • Professional liability payments made on behalf of a physician or other health care practitioners.Adverse action reports based on a physician or other health care practitioner’s professional competence or conduct that adversely affects privileges for more than 30 days. These actions include reducing, restricting, suspending, revoking, or denying privileges, and also include an entity’s decision not to renew a physician’s or other health care professional’s privileges if the decision was based on competence or professional misconduct. It also includes voluntary surrender of license or restriction of privileges either while under investigation or in lieu of an investigation. Voluntary surrenders relating to retirement, nonpayment of licensure renewal fees, and change to inactive status, if there is not an investigation in progress, are not reportable.
  • Disciplinary actions related to competence or professional misconduct taken against a physician’s license, including revocation, suspension, censure, reprimand, probation, and licensure surrender.
  • Professional society review actions taken for reasons related to competence or professional misconduct that adversely affect membership in the professional society.
  • Medicare and Medicaid exclusion reports containing sanctions against a practitioner from the Medicare program or the Medicaid program due to fraud and abuse.

Updated definition 2020:

NPDB is an electronic registry of all payments made on behalf of physicians in connection with medical liability settlements or judgments as well as adverse actions typically related to professional conduct or competence. Per Federal Law, information regarding all medical liability settlements and certain adverse actions (see list below) must be reported to the NPDB and be made available to hospitals, licensure boards, some professional societies and occasionally some other health care bodies. In general, reports need to be filed to the NPDB within 30 days of the action.

Actions reported to the NPDB:

  • Payments made for Medical Malpractice
  • State Licensure and Certification actions
  • Federal Licensure and Certification actions
  • Negative findings/actions by a peer review organization
  • Negative findings/actions by a private accreditation organization
  • Health care related civil or criminal convictions in State or Federal court
  • DEA controlled substance registration actions
  • Exclusion from participation in a federal or state health care program (i.e. Medicare, Medicaid)

60%

Answered correctly

2020

Year asked

15%

Answered correctly

2013

Year asked

Author
Sam MacCormick, MD