National Practitioner Data Bank
August 24, 2016 | Healthcare Risk, Quality, & Safety Guidance
In establishing the NPDB, Congress sought to address the phenomenon of increasing medical malpractice litigation and the need to improve the quality of medical care at a national level and to reduce fraud and abuse in healthcare. The effort also aimed to curb the ability of physicians and dentists who are incompetent or who have been professionally disciplined to relocate to another healthcare facility or state without their negative professional reputations and performance histories being discovered.
The NPDB collects and disseminates information about medical malpractice payments and certain adverse actions against healthcare practitioners, entities, providers, and suppliers to eligible entities. It also receives and discloses to eligible entities certain final adverse actions taken by federal and state agencies and health plans against healthcare practitioners, providers, and suppliers. Final adverse actions include licensure and certification actions, healthcare-related criminal convictions and civil judgments, exclusions from federal or state healthcare programs, and other adjudicated actions or decisions. Information from the NPDB is available only to entities and others that are specified as eligible pursuant to certain statutes and regulations.
In an effort to curb fraud and abuse in healthcare, Congress also enacted legislation authorizing the creation of a second national data bank, the Healthcare Integrity and Protection Data Bank (HIPDB). In March 2000, HIPDB began receiving and disclosing to eligible entities certain final adverse actions taken by federal and state agencies and health plans against healthcare practitioners, providers, and suppliers. In 2013, the HIPDB and NPDB merged. Consequently, information previously collected and disclosed by the HIPDB is now collected and disclosed by the NPDB, which continues to collect and provide information concerning medical malpractice payments and certain adverse actions to eligible entities.
The NPDB is a repository of more than 1.26 million reports, including adverse action reports, healthcare-related judgment or conviction reports, and reports of medical malpractice payments. See What Is the NPDB? for more information.
The information disseminated by NPDB to eligible entities is intended to alert them that there may be a problem with a particular practitioner, entity, provider, or supplier, suggesting the need for more comprehensive review. NPDB information is intended to be used in combination with information from...