Is It Reportable?

If a physician's initial application for clinical privileges is denied or the privileges granted are more limited than those requested, must this be reported to the NPDB?

If the denial or limitation of privileges is the result of a professional review action and is related to the practitioner's professional competence or professional conduct, then the action must be reported to the NPDB. If the denial or limitation of privileges occurs solely because a practitioner does not meet a health care institution's established eligibility threshold criteria for that particular privilege (e.g., lacks the required number of clinical hours in a specialty), it should not be reported to the NPDB. The latter type of restriction or denial is not deemed the result of a professional review action relating to the practitioner's professional competence or professional conduct.

Add Your Mobile Phone Number to Your Account Today

In our continuing effort to improve our users’ experience, you will soon be able to receive a temporary password sent as a text message to your mobile phone.

To prepare for this enhancement, simply add your mobile phone number to your user account by doing the following:

1. Sign into your NPDB user account.
2. Select the Update User Account option.
3. Add your mobile phone number to your NPDB user account, and select Save.

The release date for this enhancement will be shared in a future edition of NPDB Insights.

Focus on Health Center Attestation

Beginning later this year, as part of the NPDB’s ongoing compliance efforts, health center users renewing their organization’s NPDB registration will additionally need to attest that their organization has reported all reportable clinical privileges actions to the NPDB. Health center attestation is one component of a larger project that will require other reporting entities to attest as well (such as hospitals, medical malpractice payers, and health plans), and it is similar to the attestation the NPDB already requires for licensure boards.

Every two years, during NPDB registration renewal, federally funded health centers and federally qualified look-alikes are asked to confirm that all reportable clinical privileges actions have been submitted to the NPDB. If your health center is responsible for making privileging and/or credentialing decisions for other sites in your scope of project, those sites will be included in the attestation.

Health centers provide primary health care services to patients, regardless of their ability to pay. Health centers are considered "other health care entities" for the purposes of NPDB querying and reporting. Health centers that have a formal peer review process meet the regulatory definition of a health care entity, and are therefore authorized as an eligible entity that is allowed to query and required to report to the NPDB.

When you receive notification to complete your health center’s entity registration renewal, you will also be asked to complete your attestation. Detailed instructions are available when you sign into your NPDB account.

For additional information, please visit the Health Centers page on the NPDB website.