Title IV of the Health Care Quality Improvement Act of 1986 established the National Practitioner Data Bank. The Data Bank maintains records of malpractice judgments and disciplinary actions against doctors and other health care professionals. The Data Bank has been in operation since September 1, 1990.
Hospitals and other health care entities, professional societies, and state licensing agencies submit reports of adverse actions against health care practitioners to the Data Bank. These entities are required to report adverse actions against physicians and dentists and may submit reports concerning other health care professionals. Reportable actions are based on a physician’s or dentist’s professional competence or professional conduct which adversely affects, or could adversely affect, the health or welfare of a patient. Specifically, reporting entities are required to report the following:
- Hospitals and health care entities are required to report professional review actions that adversely affect a physician’s or a dentist’s clinical privileges for a period of more than 30 days.
- Hospitals and health care entities are requires to report acceptance of a physician’s or dentist’s surrender or restriction of clinical privileges while under investigation for possible professional incompetence or improper professional conduct or in return for not conducting an investigation or professional review action.
- State licensing agencies must report certain disciplinary actions related to professional competence or conduct taken against the licenses of physicians or dentists, including revocation, suspension, censure, reprimand, probation, and surrender.
- Professional societies must report professional review actions based on reasons related to professional competence or conduct which adversely affect the membership of a physician or dentist.
Malpractice insurers are required to report any payments made on behalf of the practitioners they insure. Malpractice insurers must report any payment made, whether the result of a court judgment, settlement, or arbitration. The reports must be made within 30 days from the date the payment is made. Health care practitioners who make payments on their own behalf in response to malpractice claims are not required to report such payments.
The Data Bank can only release records to certain authorized entities including hospitals and other health care entities, state licensing agencies, professional societies, and, in some cases, to plaintiffs’ attorneys prosecuting medical malpractice actions. The information contained in the Data Bank is considered confidential, and the Data Bank utilizes a comprehensive security system to prevent unauthorized access to the information contained in it.