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National Practitioner Data Bank (NPDB)

National Practitioner Data Bank (NPDB) | Healthcare Integrity And Protection Data Bank (HIPDB)

Title IV of Public Law 99-660, the Health Care Quality Improvement Act of 1986, as amended, established the National Practitioner Data Bank (NPDB) as an information clearinghouse to collect and release certain information related to the professional competence and conduct of physicians, dentists and, in some cases, other health care practitioners. Originally the operations of the NPDB were directed only toward collecting and releasing information under Title IV. However, in 1987, Congress passed Public Law 100-93, Section 5 of the Medicare and Medicaid Patient and Program Protection Act of 1987 (Section 1921 of the Social Security Act), authorizing the government to collect information concerning sanctions taken by state licensing authorities against all health care practitioners and entities.

Section 1921 was enacted to provide protection from unfit health care practitioners to beneficiaries participating in the Social Security Act’s health care programs and to improve the anti-fraud provisions of these programs. Congress later amended Section 1921 with the Omnibus Budget Reconciliation Act of 1990, Public Law 101-508, to add “any negative action or finding by such authority, organization, or entity regarding the practitioner or entity.” The U.S. Department of Health and Human Services (HHS) issued a Notice of Proposed Rulemaking for Section 1921 on March 21, 2006 and issued the Final Rule for Section 1921 of the Social Security Act as published in the Federal Register on Jan. 28, 2010. The Data Banks opened Section 1921 for reporting and querying on March 1, 2010.

Section 1921 expands the information collected and disseminated through the NPDB to include reports on all licensure actions taken against all health care practitioners, not just physicians and dentists, as well as health care entities. Peer review organizations and private accreditation organizations must report any negative actions or findings taken against health care practitioners or organizations. Queries have access to state licensure actions taken against all health care practitioners and Section 1921 provides limited querying by quality improvement organizations, federal and state health care programs, state Medicaid fraud control units and other law enforcement agencies. Section 1921 also will allow entities new to the NPDB to access Section 1921 data through the NPDB.

Contact Our License Defense Law Firm

To learn more about the National Practitioner Data Bank and how it can affect your professional license, contact The Law Offices of Brian E. Quinn. We provide experienced assistance with all license defense issues, helping our clients make the right decisions to protect their rights and their futures. To schedule a consultation with one of our attorneys, call 215-545-3338 or contact us online.