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State Licensure Reporting Requirements Webinar
The State Licensure Reporting Requirements Webinar was held on June 27, 2023.
Watch the recording for the Webinar Exit Image
(video - 1:08:56)
Event Materials
- Presentation Slides (PDF - 1.05 MB)
Q&As
- Are there reporting differences between states?
No. All state licensing boards must report certain actions (referred to as state licensure and certification actions) taken against health care practitioners, entities, providers, or suppliers, as defined by NPDB statutes and regulations. - Does the NPDB require entities to forward copies of all reports to state licensing boards?
No. The NPDB forwarding requirement pertains only to entities that submit malpractice payments and clinical privileges and professional society actions. The NPDB provides an Electronic Report Forwarding Service that allows reporting organizations to provide certain reports directly to the appropriate state licensing boards. The reporter receives a notification when the state licensing board views the report. It is the reporting entity's legal responsibility to ensure the state board has received the forwarded report. - How long does the state board have to report actions to the NPDB?
You must submit all reports to the NPDB within 30 days of the board action. However, if a state board discovers that a required report was not previously submitted to the NPDB, the state board must promptly file the related report(s). - Our board issued a formal "cease and desist" order to an unlicensed practitioner who claimed to be a licensed dentist. Should the action be reported to the NPDB?
Yes. NPDB regulations define a health care practitioner as "an individual who is licensed or otherwise authorized by a state to provide health care services (or any individual who, without authority, holds himself or herself out to be so licensed or authorized)." When reporting an action against an unlicensed individual, select "No License" on the licensure information screen and select the field of licensure claimed by the individual for the Occupation/Field of Licensure category. - What should a state board do if they believe a report should be in the NPDB, but the report is not there?
If an entity believes that a reportable action was not submitted to the NPDB based on information received in a query response, the entity should go to the Subjects Queried page (or the Multiple-Name Query Responses page for bundled responses), click the Reporting Compliance link, and provide the information regarding the missing report. - Are state licensing boards required to submit reports on private orders?
If the board took an adverse action, it is reportable to the NPDB. It is not what a board calls an action that determines its reportability, it is the action that the Board takes. Adverse actions do not need to be publicly available to be reportable. - Can a state board use the NPDB as a screening tool for pre-licensure and for randomized renewal audits?
Yes. The state board can query the NPDB if a practitioner applies for licensure. Additionally, the Board can query the NPDB at any point once the practitioner obtains a license for an authorized purpose. - If a state licensing or certification authority takes an action that is later expunged, should the state licensing or certification agency report the expungement?
Yes. If the reporting entity expunges a record or finds that one of its records has been expunged, it shall file a Revision-to-Action Report with the NPDB to note the expungement. An expunged record is not a reason to void a report. An expungement removes the practitioner's public record but does not vacate or change the action. - As a result of a formal proceeding, a state licensing or certification authority reprimanded a practitioner. In addition, the authority imposed a publicly available, technical, administrative fine, which is not an adverse action, in the amount of $500. Should this administrative fine be reported to the NPDB?
State licensing or certification authorities must report negative actions that result in administrative fines (i.e., fines that are administrative or technical in nature) if: (1) they are publicly available and (2) they are either connected to the delivery of health care services or taken in conjunction with other adverse licensure or certification actions. - In some states, an agency other than a licensing board (such as a state department of health) may be responsible for taking actions against unlicensed providers. Are these other agencies required to report the actions they take?
Yes. Licensure and certification actions taken by states as a result of formal proceedings that must be reported include:
- Revocation or suspension of a license or certification agreement or contract for participation in a government health care program, reprimand, censure, or probation
- Any dismissal or closure of the formal proceeding by reason of the health care practitioner, health care entity, provider, or supplier surrendering the license or certification agreement or contract for participation in a government health care program, or leaving the state or jurisdiction
- Any other loss of license or loss of the certification agreement or contract for participation in a government health care program, or the right to apply for, or renew, a license or certification agreement or contract of the health care practitioner, health care entity, provider, or supplier, whether by operation of law, voluntary surrender, nonrenewal (excluding non-renewals due to nonpayment of fees, retirement, or change to inactive status), or otherwise
- Any negative action or finding by such authority, organization, or entity regarding the health care practitioner, health care entity, provider, or supplier.
