NPDB Insights - April 2021

Is It Reportable?

Does a medical malpractice payment have to exceed a certain dollar amount before it is reportable to the NPDB?

No. There is no minimum payment amount threshold. Medical malpractice payments of any amount that meet the reporting criteria should be reported to the NPDB.

Step-by-Step: Reporting Medical Malpractice Payments

Entities (including medical malpractice insurers and self-insured organizations) must submit a Medical Malpractice Payment Report if they make a payment for the benefit of a health care practitioner in settlement of, or in satisfaction in whole or in part of, a written claim or complaint against that health care practitioner, and additionally, each of the following must be true:

• There is an exchange of money;
• The payment is the result of a written complaint or claim demanding monetary payment for damages (based on the practitioner's provision of or failure to provide health care services); and
• The practitioner is named or sufficiently described in both the complaint or claim, and in the settlement, release, or final adjudication (or the practitioner's name was removed as a condition in the settlement or release).

For more tips on when to submit a medical malpractice payment report, visit our NPDB Reporting Guide and the NPDB Guidebook.

How to Submit a Medical Malpractice Payment Report

1. Sign in to the NPDB and select Report on the Select an Option page.
2. On the Identify the Subject page, select that the subject is an individual, then enter the practitioner's name.
   Exit

   Identify the Subject

   
3. Select the type of action on the following page.
   Exit

   Select the Action

   
4. Complete the Subject Information section. Be sure to fill out as much information on the subject as possible to help querying organizations find your report.
   1. Enter the practitioner's personal information, such as name and birth date.
   2. Enter the practitioner's home and work address and organization name.
   3. Enter the type of license against which the action was taken.
   4. Enter the schools or institutions the practitioner attended for their professional degree(s), training(s), or certification(s).
   5. Enter the practitioner's known identification numbers, which could include Social Security Number, National Provider Identifier, or Drug Enforcement Administration Number.
   6. Enter all of the practitioner's hospital affiliations.
   Exit

   Subject Information

   
5. Complete the Action Information section.
   1. Enter the payment information, such as the amount, the date of payment, whether the payment represents a single final payment or one of multiple payments, the total amount to be paid, and what the payment was a result of (e.g., a settlement).
   2. Enter the date of judgment, the name of the adjudicative body, the case number, and the court file number.
   3. Describe the judgment, including any conditions or terms of payment, in the narrative description.
   4. Check whether or not this is a global settlement for multiple claimants and enter the total number of claimants included in the settlement.
   5. Check whether or not there are multiple practitioners included in this case and enter the total number of practitioners and the total amount to be paid for all practitioners.
   Exit

   Action Information

   
6. Complete the Payment Information section.
   1. Identify your organization's relationship with the practitioner and enter all available information regarding payments made by other organizations.
   Exit

   Payment Information

   
7. Complete the Acts or Omissions section.
   1. Enter information on the primary claimant, such as age at the time of the initial event, gender, and type of care received.
   2. Describe the primary claimant's medical condition and treatment and the procedure(s) performed in the narrative description sections.
   Exit

   Acts Or Omissions

   
8. Complete the Allegation(s) and Outcome section.
   1. Select the nature of the allegation, enter the date of the event or incident, and enter the specific allegation. Then describe the allegation.
   2. Select the outcome of the allegation and describe the allegations and injuries (or illnesses) that form the basis for the action or claim.
   Exit

   Allegation(s) and Outcome

   
9. Review the information you provided to ensure it is correct, then complete the Certification section.
10. Save or print a copy of the report on the Report Submission Complete page for your records.
11. As noted in the NPDB Guidebook, entities are not excused from reporting simply because they missed a reporting deadline. Reports must still be submitted as soon as possible after a deadline is missed.

For more comprehensive instructions and requirements for medical malpractice payments, see the NPDB regulations and the NPDB Guidebook.

Looking for information on how to submit other types of reports? Check out our Introduction to Reporting, Reporting Clinical Privileges Actions, and Reporting State Licensure Actions articles. Keep an eye on NPDB Insights for upcoming articles on how to report health care-related civil judgments, health care-related criminal convictions, and other adjudicated actions or decisions.

Dear NPDB

What is Continuous Query?

Querying the NPDB serves an essential function of heightening accountability in the health care community and increasing patient safety.

You have two options for querying the NPDB: One-Time Query and Continuous Query. While they both provide an initial query response and fulfill legal and accreditation requirements, Continuous Query provides additional features and benefits over One-Time Query for the same cost.

In addition to the features above, reports received using Continuous Query are disclosed an average of 10 months sooner than reports received using One-Time Query!

With the additional features of Continuous Query, your organization has the most up-to-date information on your enrolled practitioners and can make more informed hiring, licensing, privileging, and credentialing decisions.

Don't know how to start using Continuous Query? Visit our How to Activate Continuous Query page, and check out our new Why Choose Continuous Query? infographic.