NPDB Guide to Reporting Clinical Privileges Actions

NPDB guide to Reporting Clinical Privileges Actions

Before Submitting:

Are you a hospital or health care entity that took a professional review action agaisnt a physician or dentist?*

Report the professional review action if both A and B are met:

A: Adversely affects clinical privileges (including privilegdes, medical staff or panel membership, network participation, affiliation and other circumstances) for a period of more than 30 days, including:

• Reducation, restriction, suspension or revocation of privileges
• Denial of privileges based on a professional review action (excluding denials based on failure to meet specific threshold criteria or an initial application withdrawal before a final professional review decision)
• A practitioner's surrender of, or failure to renew, privileges while under or to avoid investigation
• Summary suspensions that are result of a professional review (in effect for more than 30 days), regardless of whether the action is final

B: Is based on the practitioner's professional compentence or professional conduct that adversely affects or could adversely affect the health or welfare of a patient.

If both A and B are met, Submit an Initial Action Report, within 30 days of when the action was taken.

You must forward a copy of the report to your state licensing board in the NPDB system (or by mail).

Report Modifications (when needed):

The NPDB notifies the subject of a report when a report is submitted and when any of these modifications are made.

• Did you organization take an action that modifies or relates to a previously reported action (including reinstatements)? If yes, Submit a Revision to Action report.
• Did your organization determine there is an error or omission in a previously submitted report? If yes, submit a Correction Report.
• Did your organization determine that an action should not have been reported because:
  • The report was erroneously submitted?
  • The action is not reportable?
  • The action was revered or overturned?

  These are the only reasons for which a report may be voided.