Is It Reportable?

A physician applied to a hospital for clinical privileges to perform cardiac procedures. The hospital requires that such applications be granted only if the applying physician has performed 50 cardiac procedures in the previous year. The applying physician has performed only 40 such procedures. The hospital denies the application based solely on the physician not having met its 50-procedure requirement. Should this denial be reported to the NPDB?

No. A denial of clinical privileges that occurs solely because a practitioner does not meet a health care institution's established threshold criterion for that particular privilege should not be reported to the NPDB. Such denials are not considered to be the result of a professional review action relating to the practitioner's professional competence or professional conduct but, rather, are considered to be decisions based on eligibility that are not reportable.

Introducing the NPDB’s Policy Corner

In response to your questions about the laws and regulations governing NPDB operations, the Policy Corner has been added to the NPDB Help Center. NPDB's Policy Corner is intended to help you understand how to practically apply NPDB reporting and querying policies, through the following resources:

• Is It Reportable? scenarios that answer real-world reporting questions.
• New Policy Guidance that provides additional guidance for frequently asked questions on such topics as reporting medical malpractice payments, impaired practitioners, and private agreements. Content will be updated regularly.
• Policy Q&A topics including eligibility, reporting medical malpractice payments, reporting clinical privileges actions, reporting state licensure actions, and more.
• An "Ask the NPDB Team" button for quick answers to policy questions.
• Links to important resources such as the Guidebook, statutes and regulations, and fact sheets.

The NPDB is always seeking better ways to serve you, and we welcome your suggestions for future updates to the Policy Corner.

Compliance Pages Easier to Navigate, Include New Compliance Infographic

To further its mission of improving the quality of health care, and reducing fraud and abuse, the NPDB continues its compliance effort to improve the completeness and accuracy of data reported to the NPDB. Most recently, the NPDB released the results of its latest compliance review in August 2016. This review examined state licensing and certification board adverse actions taken between January 2013 and December 2014 for 13 states.

The review compares adverse actions taken by state licensing and certification boards to the reports the boards submit to the NPDB, with the purpose of ensuring that all actions that must be reported according to federal law have been correctly reported to the NPDB. It includes professions that are queried most often by organizations registered with the NPDB, plus a random sampling of other professions. All states and territories are reviewed every two years. The NPDB continues to work with state boards that need assistance with meeting federal reporting requirements.

The NPDB has always shared the results of its reviews organized by state and by profession, but now offers a compliance map infographic that combines the two, showing on the U.S. map what states and territories were reviewed. Only the boards and professions listed were part of the compliance review and received a status of "compliant", "non-compliant", or "working toward compliance." A state's overall compliance status is not reflected in this infographic. For full compliance results, visit Reporting Compliance Status by State.

In addition to the new infographic, several enhancements were made to the compliance pages, providing a new look and feel, making it easier to navigate, and making it a better workforce tool. For instance, when your mouse hovers over a row in the tables of states or professions, the row will appear grey to indicate what row you are on. Enhancements to these pages will benefit many state board users who verify their compliance with the NPDB's compliance officers.