NPDB Insights

Is It Reportable?

Must a hospital or other health care entity report adverse actions concerning the clinical privileges of medical and dental residents and interns?

The action is not reportable if it was taken within the scope of the training program. Since residents and interns are trainees in graduate health professions education programs, they are not granted clinical privileges per se but are authorized by the sponsoring institution to perform clinical duties and responsibilities within the context of their graduate educational program. However, a resident or intern may practice outside the scope of the formal graduate education program - for example, moonlighting in the intensive care unit or emergency department. Adverse clinical privileges actions related to practice occurring outside the scope of a formal graduate educational program must be reported.

July Compliance Review Completed

The NPDB is pleased to provide the results of our compliance review, which examined reporting compliance for disciplinary actions taken between January 1, 2014 and December 31, 2015 for the following states: Alabama, Connecticut, Florida, Georgia, Hawaii, Kentucky, Missouri, New Hampshire, Oklahoma, Rhode Island, South Carolina, West Virginia, and Wisconsin. In addition, the initiative also included the following U.S. Territories: American Samoa, Northern Mariana Islands, Guam, Puerto Rico, and the U.S. Virgin Islands. The results are presented for each state/territory, board, and profession. An explanation of the compliance status definitions is available on the NPDB website. For full compliance results, visit Reporting Compliance Status by State.

The NPDB congratulates all of the state boards that achieved the "compliant" status by July 1, 2017. The NPDB would like to thank all of the state boards for their hard work in meeting NPDB reporting requirements. We continue to work with state boards that need assistance with meeting federal reporting requirements. Please send inquiries to dpdbcompliance@hrsa.gov.

When Should Your Organization Query the NPDB?

The NPDB is a health care workforce tool designed to provide important information to organizations, and to facilitate dialogue between the organization and the practitioner. Entities authorized to query the NPDB are permitted to do so for the following reasons:

• Privileging
• Employment
• Professional review activities
• Mandatory two-year review of clinical privileges or medical staff membership (hospitals)
• Licensing or certification
• Fraud and abuse investigation
• Certification to participate in a government program
• Claims processing

Hospitals are required to query the NPDB for every member of their privileged staff at initial appointment, and every two years thereafter. Health care organizations such as federally-qualified health centers, long-term care facilities, HMOs, and others use the NPDB query response as part of their review and credentialing process. Many accreditation organizations such as the Joint Commission, DNV, and AAAHC require organizations to query the NPDB.

If your organization performs any of these activities, and is eligible and registered to query, an NPDB query response will enrich your credentialing and decision-making process. NPDB information is intended to be used in combination with information from other sources, and should not be used as a sole-source verification of professional credentials.

The latest updates and resources are available at https://www.npdb.hrsa.gov.

Previous editions of NPDB Insights are available in our archive.