logo
logo
logo
MENU
Categories
Hospitals and Health Systems - Audits and ReimbursementHospitals and Health Systems - Consent and TreatmentHospitals and Health Systems - Corporate and GovernanceHospitals and Health Systems - Corporate ComplianceHospitals and Health Systems - Fraud and AbuseHospitals and Health Systems - Government InvestigationsHospitals and Health Systems - Health RecordsHospitals and Health Systems - HIPAA and HITECHHospitals and Health Systems - Managed CareHospitals and Health Systems - Medical Staff IssuesHospitals and Health Systems - Medical Training ProgramsHospitals and Health Systems - MedicareHospitals and Health Systems - Mergers, Affiliations and Joint VenturesHospitals and Health Systems - Peer ReviewHospitals and Health Systems - Professional Services AgreementsMedical SocietiesPharmaceutical Industry - Agreements with PhysiciansPharmaceutical Industry - Clinical ResearchPharmaceutical Industry - Regulatory CompliancePhysicians and Providers - Audits and ReimbursementPhysicians and Providers - CertificationsPhysicians and Providers - CredentialingPhysicians and Providers - Disciplinary ActionsPhysicians and Providers - Employment AgreementsPhysicians and Providers - Fraud and AbusePhysicians and Providers - Government InvestigationsPhysicians and Providers - HIPAA and PrivacyPhysicians and Providers - ImpairmentPhysicians and Providers - LicensingPhysicians and Providers - LitigationPhysicians and Providers - MedicarePhysicians and Providers - Peer ReviewPhysicians and Providers - Practice AcquisitionsPhysicians and Providers - Practice IssuesPhysicians and Providers - Regulatory CompliancePhysicians and Providers - SupervisionPhysicians and Providers - TrainingUncategorized
David N. Vozza
Member
David N. Vozza
Visit Profile

Appealing NPDB Reports

COVID-19 CARES Act Coronavirus Provides Financial Relief for Health Care Providers - $30 Billion Is Being Infused Into the Health Care System: Who Is Receiving Money and What You Should Know If You Keep It

Physicians must be aware that a full reporting of all adverse events, whether malpractice awards/settlements, license restrictions, hospital privilege issues, or insurance payor terminations, are set forth in a semi-public and centralized database known as the National Practitioner Data Bank (NPDB). A physician’s NPDB report must be treated as a credit report, checked regularly, and its contents appealed where appropriate. Physicians are encouraged to retain health care counsel to navigate such challenges.

How the NPDB Works

A searchable database of adverse actions taken against physicians has existed in some form since 1986, pursuant to the Health Care Quality Improvement Act. The NPDB assumed its current form in 2013 when two other databases merged. It contains information about the following adverse actions taken against a physician:

  • Judgments against the physician in civil and criminal court
  • Restrictions, suspensions, or revocation of medical license
  • Loss or restriction of clinical privileges at a hospital
  • Loss of membership in a professional organization
  • Disciplinary actions by licensing and certification agencies
  • Loss of eligibility to provide care through Medicare or Medicaid

However, the information in the NPDB is not available to the general public. Only state licensing boards, insurance payors, and hospitals can search for it. The publicly searchable portion of the NPDB contains only anonymized summaries of disciplinary actions taken against physicians in general. Patients cannot tell which physician received which disciplinary action, only that X number of doctors in the state of New York had their licenses suspended in a given year.

Appealing an NPDB Report About You

Unfortunately, a single NPDB report can have drastic and long-lasting ramifications. Indeed, any agency, payor, or hospital that receives a report can (and typically does) commence its own investigation, which can lead to a cascade of subsequent adverse events. Physicians are not without recourse, however. The NPDB website contains an option to dispute reports by submitting a counter-statement to the report. Physicians can also place a report in dispute, triggering an internal appeals process. These challenges are unique to the NPDB system and should be handled by attorneys who have extensive experience in health care law.

Contact Norris McLaughlin About Disputing NPDB Reports

If you have any questions about this or any other legal health care matter, please email me at dnvozza@norris-law.com.

Share
Related Posts
Steering Clear of the OPMC in NY
Medical Malpractice “Crisis” Back in the News
IMPAIRED PHYSICIANS - Health Care Counsel Can Help Navigate the Rough Waters
David N. Vozza
Member
David N. Vozza
Visit Profile
Related Posts
Steering Clear of the OPMC in NY
Medical Malpractice “Crisis” Back in the News
IMPAIRED PHYSICIANS - Health Care Counsel Can Help Navigate the Rough Waters
Share
Join our growing team
We are looking for quality attorneys to help us do more for our clients. At Norris McLaughlin, each attorney has the same opportunity to succeed whether you’re at the beginning of a career or pinnacle of the profession.
Subscribe to our content
Receive timely legal information
delivered to your inbox
Subscribe to our content
Receive timely legal information
delivered to your inbox
© 2022, Norris McLaughlin, P.A., All Rights Reserved. Attorney Advertising.
Meritas

We use cookies to ensure that we give you the best experience on our website. If you continue to use this site we will assume you consent to our cookie policy. Learn more