Meeting NPDB Reporting Requirements When Navigating a Peer Review Matter

Description

The NPDB reporting guidelines set forth requirements with the potential to affect any licensed healthcare provider after an adverse action or malpractice payment. The guidelines include many exceptions, however, and whether report of an adverse action or payment is required should be evaluated on a case-by-case basis.

There are many circumstances when it is not clear whether or not to file a report. Some NPDB reporting guidelines apply to healthcare practitioners other than physicians. Licensed healthcare providers should be aware of the applicable reporting requirements in the event of an adverse action. Eligible entities are required to report adverse clinical privileges actions taken against physicians and dentists and may report adverse clinical privileges actions taken against other licensed practitioners.

Peer review organizations must report certain negative actions or findings, which are defined as any recommendation by a peer review organization, based on formal proceedings of the organization, to sanction a licensed practitioner. However, it is important to note that not all healthcare organizations using peer review qualify as a peer review organization under the guidelines. Understanding who is a qualified reporter and what should be reported and when is critical.

Listen as our authoritative panel of healthcare attorneys examines NPDB reporting compliance when navigating through and settling a peer review matter. The panel will address compliance challenges involved with a peer review matter and will offer best practices for meeting the reporting requirement.