NPDB Insights - September 2024

Fee Change for Mailed Self-Queries Starts October 1, 2024

To make the NPDB's Self-Query experience more secure and to reduce the possibility of unauthorized access to Self-Query responses, the NPDB will begin sending paper Self-Query responses by U.S. Postal Service certified mail. Certified mail requires a delivery signature. While the cost of a Self-Query, including a digitally certified response, remains $3.00, beginning October 1 the supplemental fee for each mailed Self-Query response will increase from $3.00 to $13.00.

We encourage all eligible entities to query the NPDB directly rather than requesting a Self-Query response. However, if a Self-Query response is required, please only accept a digitally certified Self-Query response. Self-Query responses that are digitally certified are typically available right away, are more environmentally friendly, and are more secure than mailed Self-Query responses. A digitally certified Self-Query is a PDF that ensures the Self-Query is exactly as it was issued by the NPDB. Certified PDFs viewed with the latest free version of Adobe Acrobat Reader display a certification that the file has not been altered since its creation.

Is It Reportable?

Is a report required when clinical privileges lapse at the end of a 2-year appointment because there has been a recommendation by the Medical Executive Committee that the physician not be reappointed, but the physician's current 2-year appointment ends before a hearing can be held and final action taken by the hospital's governing body?

Yes. A non-renewal while under investigation is reportable to the NPDB. In this scenario, the investigation is ongoing at the time the renewal lapses; therefore, the non-renewal is reportable as a resignation of privileges while under investigation. The practitioner's awareness that an investigation is being conducted is not a requirement for filing a report with the NPDB.

What Do I Need to Know About Querying?

A query is a search for information contained within the NPDB regarding a health care practitioner or organization. The NPDB collects information on medical malpractice payments and certain adverse actions through reports submitted by entities that are eligible to report. Reported information is disclosed to entities that are eligible to query. In order to query the NPDB, entities must be registered with the NPDB and authorized to query. An entity’s ability to query and the type of information it may receive through querying is determined by law.

Hospitals Must Query the NPDB

Hospitals are the only health care entities mandated by federal law to query the NPDB. Every hospital must query the NPDB as follows:

• When a physician, dentist, or other health care practitioner applies for medical staff appointment or for clinical privileges at the hospital.
• Every 2 years on all physicians, dentists, and other health care practitioners who are on its medical staff or who hold clinical privileges at the hospital.

Other Entities Who May Query the NPDB

Many types of health care entities other than hospitals may query the NPDB. For a simplified list of who can query, see our NPDB: Who Can Report and Query? Infographic. Chapter D: Queries of the NPDB Guidebook contains more detailed information regarding who can query and what information they can receive.

Situations in which other entities may query the NPDB include:

• When they have or may be entering into employment or affiliation relationships with health care practitioners, providers, or suppliers.
• When a health care practitioner applies for clinical privileges or medical staff appointment at the entity.
• When the entity is engaging in professional review activity.

Hospitals and other entities can query on many different kinds of health care professionals, not just physicians and dentists. This table provides examples of other types of health care professionals who may be queried on.

Using Continuous Query

The NPDB offers multiple ways to query. We recommend using Continuous Query for the best querying experience. Continuous Query keeps you informed about your enrolled practitioners 24 hours a day, 365 days a year. You will receive email notification within 24 hours of a report received by the NPDB.

Visit our How to Activate Continuous Query page to start using Continuous Query today.

What to Expect from a Query Response

If there are reports contained in the NPDB concerning your query subject, you will receive a copy of the report(s) in your query response. If your query response states there are no reports found in the NPDB, then none of the information you provided in the query matched any reports contained within the NPDB. To make sure you receive the most accurate information from your query response, you must include as much correct identifying information on the subject of the query as possible.

For more information about querying the NPDB, check out these resources:

• Continuous Query help page
• About Querying the NPDB
• Querying infographics