As many medical staff professionals are aware, the federal government’s clearinghouse for disciplinary and malpractice information has recently implemented new regulations that expand mandatory reporting.  Named “Section 1921” for the law that expanded its scope, the National Practitioner Data Bank now collects and disseminates all licensure actions taken against all healthcare practitioners, not just physicians and dentists, as well as mandates accreditation organizations to report adverse findings made when surveying healthcare entities.

Effective March 1 2010, licensing boards, hospitals and certain professional societies must report to the NPDB adverse actions taken against all health care practitioners.  Previously, only actions based on competence or conduct taken against physicians and dentists were included in the NPDB.  Also, peer review organizations and private accreditation organizations must report any negative actions or findings taken against healthcare practitioners and organizations. While the NPDB has collected reports on all malpractice payments made on behalf of healthcare professionals since 1990, the new regulations expand the reporting requirements to include all disciplinary actions. The 2010 regulations also require that professional associations with formal peer review processes report adverse actions taken against members.  Until now, such reports by a professional association were optional.

There are two federal data banks in which the reports are collected – NPDB and the Healthcare Integrity and Protection Data Bank (HIPDB).  Reports to the HIPDB are made by federal and state licensing agencies, federal and state prosecutors, and federal and state government agencies that have excluded a practitioner, provider or supplier from their health plan.  Some state licensure actions are reported to both data banks. Since all healthcare practitioners have been included in reports to the HIPDB since it began collecting data in November 1999 concerning actions taken on or after August 21, 1996.  The March 1 regulations did not make any changes to HIPDB reporting requirements.

What do these changes mean to hospitals and other healthcare organizations?  There is no change for healthcare entities as far as mandatory reporting or querying.  To have access to section 1921 information, currently registered entities must register and self-certify their eligibility to have access to section 1921.  This registration is optional and can be found in the organization's registration profile on the administrator options screen in the IQRS online system.  With the expanded list of reporters, it is possible that a healthcare entity will be reported to the NPDB by accreditation organizations with regard to quality of care problems encountered during the survey process.  Also, there is the potential for getting more disciplinary information through NPDB query reports with the mandatory reporting expansion that includes all disciplinary actions taken against healthcare professionals as well as professional review organizations.

For more information about the new requirements, you may access the HRSA Faction Sheet on Section 1921 at this link: http://www.npdb-hipdb.com/pubs/fs/Fact_Sheet-Section_1921.pdf

 

March 18, 2010 (updated 4/19/2010)