NPDB Insights - December 2022

Is It Reportable?

The Drug Enforcement Administration (DEA) denied a physician's application to renew his DEA's registration to prescribe controlled substances because he provided false information on the application. Should this action be reported to the NPDB?

Yes. Federal licensing and certification agencies must report a formal denial of a health care practitioner's, provider's, or supplier's renewal application for licensure or certification. NPDB regulations require the reporting of:

• Any loss of a license, loss of a certification agreement or contract for participation in a government health care program
• The right to apply for, or renew, a license or certification agreement or contract of a health care practitioner, provider, or supplier, whether by operation of law, voluntary surrender, nonrenewal* or otherwise

*Note: Excluding nonrenewals due to nonpayment of fees, retirement, or change to inactive status

Keep Your Account up to Date

It's always a good idea to make sure your NPDB account is up to date! Follow these tips to make sure your account is accurate.

• Review your Continuous Query enrollments. Have your account administrator review and update your enrollments. You must add any new information about your enrolled practitioners. For example, update name and licensure changes. Make sure to cancel enrollments for those practitioners who no longer work in your organization or should no longer be queried upon.
• Review your Subject Database. If you use a Subject Database, verify that its information is current. You can use this information to pre-populate
  • Query forms
  • Report forms, and
  • Continuous Query enrollments
• Verify your user accounts. Have your administrator review your organization's accounts. You must delete all accounts for employees who no longer work at your organization. You can also add roles to your user accounts, like querying, reporting, and billing. You can also select other users to be Data Bank administrators.
• Update your registration profile. Has your organization changed any items in the list below? You can update them at any time. Visit our How to Update Profile Information page to learn how.
  • Name
  • Address
  • Tax ID number
  • Email address
  • Phone number
  • Point of contact
• Reconcile payments. Do you need receipts to reconcile NPDB charges on credit cards or bank statements? Select View Billing History to view receipts for your NPDB charges.

Visit the NPDB Help Center for more helpful tips.

NPDB Spotlight: Federal Hospitals

Federal hospitals are required to report and query the NPDB.

Reporting

Under a memorandum of understanding, federal hospitals may have to submit reports on:

• Clinical privileges
• Medical malpractice payments

Because federal hospitals are also agencies administering federal health care programs, they are also required to report the following:

• Other Adjudicated Actions or Decisions
• A formal or official final action taken against a practitioner, provider, or supplier that includes the opportunity for due process and is based on acts or omissions that affect (or could affect) the payment, provision, or delivery of a health care item or service
• Exclusions
• Exclusions of health care practitioners, providers, or suppliers from engaging in federal or state health care programs

Querying

Under a memorandum of understanding, federal hospitals may have to query the NPDB:

• When a practitioner applies for medical staff appointment or for clinical privileges (including courtesy staff and temporary privileges)
• Every 2 years on all practitioners who are on its medical staff or who hold clinical privileges at the hospital (this includes courtesy staff)

See our How Many Queries Do I Need to Run? infographic for information on sharing query responses.

The best way for federal hospitals to fulfill their querying requirements is to use Continuous Query. Continuous Query keeps you informed about your enrolled practitioners 24 hours a day, 365 days a year. You will receive email notifications within 24 hours of a report received by the NPDB.

Visit our About Continuous Query page for more information.