For Title 38 employees, like most medical professionals, learning you’re being reported to the National Practitioner Data Bank (NPDB) can feel like career-ending news.
Whether you’re facing a licensing issue, disciplinary action, or judgment in a malpractice case, an NPDB report can have serious, lasting consequences.
Since these reports are permanent, a damaging one can limit your hiring opportunities and clinical privileges for the rest of your career in healthcare.
However, practitioners have more options than they realize when handling these reports and potentially reducing their long-term damage.Â
This guide will explain what every Title 38 employee should know about NPDB reports.
Our experienced Title 38 lawyers answer some common questions, including:
- What actions trigger an NPDB report?
- What happens if you are reported to NPDB as a Title 38 employee?
- Are there strategies to avoid a negative report?
- When should I hire a lawyer in an NPDB dispute?
We’ll also explain how the support of a legal professional can be essential for protecting your rights and potentially reducing the long-term damage of an adverse NPDB report.
Request a consultation by calling (800) 801-0598 or filling out our online form today.
How Does National Practitioner Data Bank Reporting Work?
The NPDB is a confidential online database that tracks reports of adverse actions involving medical practitioners. Congress created it in 1986 to improve the quality of healthcare by holding providers accountable for fraud, abuse, and substandard performance.Â
Hospitals, clinics, state licensing authorities, government agencies, professional organizations, and insurance companies are all required to report certain events to the NPDB, including:
- Medical malpractice payments (including out-of-court settlements);
- Suspension, revocation, or other restriction of federal and state medical licensing;
- Adverse actions involving clinical privileges;
- Criminal convictions and civil judgments involving healthcare providers;
- Negative actions by peer review organizations or professional societies; and
- Exclusions from federal or state healthcare programs.
Under federal law, a report must be made to the NPDB within 30 days of the adverse event’s occurrence. For example, if there’s an investigation into reportable misconduct at a hospital, the deadline for reporting it to the NPDB is 30 days from the investigation’s conclusion and final disciplinary action.
What Happens If You Are Reported to NPDB?
National Practitioner Data Bank reporting can lead to serious professional issues for Title 38 employees.
Depending on the circumstances, the consequences of an NPDB report can include:
- Loss of credentialing,
- Denial or limiting of staff privileges,
- Suspended or revoked medical license,
- Exclusion from health plan participation, and
- Increases in professional liability insurance premiums.
The impact of an NPDB report on your career depends largely on the situation and the outcome of any misconduct.
The National Practitioner Data Bank Severity Scale
The National Practitioner Data Bank severity scale is a tool the NPDB uses to express the gravity of a practitioner’s potential misconduct in situations of alleged medical malpractice.
When a reporting entity files a Medical Malpractice Payment Report (MMPR), it must include information about the impact of the alleged malpractice.Â
The scale recognizes the following levels of injury:
- Emotional injury;Â
- Insignificant injury;Â
- Minor temporary injury;Â
- Major temporary injury;
- Minor permanent injury;
- Significant permanent injury;
- Major permanent injury;Â
- Quadriplegia, severe brain damage, life-long care or fatal prognosis; andÂ
- Death.Â
If you’re the subject of an NPDB report while at the Veterans Administration or National Institutes of Health, this information stays with you for the rest of your career.
All public and private healthcare organizations review the NPDB database when hiring practitioners. The reports never expire, and retractions are extremely rare.
What Can I Do to Dispute the NPDB or Avoid Reporting?
The best way to lessen the damage of a report to the NPDB: avoid reporting entirely by resolving an issue through avenues that don’t require a record. For example, certain investigations may become reportable events when they extend beyond 30 days.
However, if the investigation is resolved with a positive outcome for the practitioner before 30 days have passed, a report may not be necessary.Â
Practitioners often can’t entirely prevent an NPDB report from being created. Fortunately, there are still some strategies that can help mitigate the potential damage of a report on their career. Let’s take a look at some of the ways that Title 38 employees can reduce the possible fallout of an NPDB report.
Have Input on the Wording
As a practitioner, it’s in your best interest to have some say in the report’s content. If possible, collaborate with the reporting entity throughout the composition process.
Your input can be valuable in confirming that the report is factually complete, with all relevant details of the incident included. Ensuring accuracy can be a powerful way to lessen some of the report’s potentially negative impact.
Initiate a Dispute with NPDB
When a hospital, healthcare center, or other reporting entity files an NPDB report about you, you receive a copy. If you have issues with the content and the reporting entity won’t agree to revise, you can file a formal dispute with the NPDB.
The Department of Health and Human Services Secretary will review the matter for factual accuracy and may order a correction.Â
Add Your Side of the Story
Medical practitioners also have the power to add a supplementary statement to an existing NPDB report. This statement can be a helpful way to clarify your involvement in an incident or add details missing from the original report. Also, any added statements are sent out retroactively to anyone who viewed your report in the prior three years.
Contact a Lawyer
Support from a legal professional can significantly impact combating a negative report. For Title 38 practitioners, an attorney’s knowledge can be invaluable at all stages of dealing with an NPDB report.
A lawyer can help:
- Ensure reporting entities follow proper adverse action procedures,
- Advise you on resolving a dispute before a report is generated,
- Arrange for dismissal from medical malpractice settlements to avoid an unnecessary report,
- Negotiate for your say in wording a report,Â
- Guide you in crafting a successful supplementary statement, and
- Protect your rights throughout the process.
You don’t have to wait until a report exists to contact an attorney for support. Ultimately, consulting with a lawyer as early as possible is the best strategy for effectively handling an NPDB report.
Defending Title 38 Employees for Over 20 Years
There’s no denying that the possibility of an NPDB report should be a serious concern for any Title 38 employee. However, this news doesn’t have to mean the end of your career. If you’re concerned about an impending or existing report, contact Pines Federal immediately.
Our attorneys have over six decades of combined experience helping Title 38 practitioners navigate NPDB reports and adverse action disputes. Contact our office online or call (800) 801-0598 today to learn how our experienced advocates can help you.