National Practitioner Data Bank Fact

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National Practitioner Data Bank Fact Sheet for the General Public

NPDB helps identify and discipline unprofessional healthcare practitioners.

Background of the National Practitioner Data Bank

The National Practitioner Data Bank (NPDB) was established through Title IV of Public Law 99-660, the Health Care Quality Improvement Act of 1986, as amended. Final regulations governing the NPDB are codified at 45 CFR Part 60. Responsibility for NPDB implementation resides in the Bureau of Health Professions, Health Resources and Services Administration, U. S. Department of Health and Human Services (HHS).

The intent of Title IV is to improve the quality of health care by encouraging hospitals, State licensing boards, and other health care entities, including professional societies, to identify and discipline those who engage in unprofessional behavior; and to restrict the ability of incompetent physicians, dentists, and other health care practitioners to move from State to State without disclosure or discovery of previous damaging or incompetent performance.

The NPDB is primarily an alert or flagging system intended to facilitate a comprehensive review of health care practitioners' professional credentials. The NPDB acts as a clearinghouse of information relating to medical malpractice payments and adverse actions taken against the licenses, clinical privileges, and professional society memberships of physicians, dentists, and other licensed health care practitioners. Hospitals and other health care entities, including professional societies, and State licensing boards should use the information contained in the NPDB in conjunction with information from other sources when granting clinical privileges or in employment, affiliation, or licensure decisions.

The NPDB is committed to maintaining accurate information and ensuring that health care practitioners are informed when medical malpractice payments or adverse actions are reported concerning them. When the NPDB receives a Medical Malpractice Payment Report or an Adverse Action Report, the practitioner receives a copy of the information submitted by the reporting entity. A practitioner who disagrees with a Medical Malpractice Payment Report or an Adverse Action Report and cannot resolve the issue with the reporting entity may add a statement to the report, dispute the report, or both.

Availability of NPDB Information

Entities entitled to participate in the NPDB are defined in the provisions of P.L. 99-660 and the NPDB regulations. Each entity must certify its eligibility to the NPDB in order to report to and/or query the NPDB.

The information from the NPDB is available to State licensing boards; hospitals and other health care entities; professional societies; certain Federal agencies; and others as specified in the law to provide information on the professional competence and conduct of physicians, dentists, and, in some cases, other health care practitioners. Hospitals are the only health care entities with mandatory requirements for querying the NPDB. Practitioners may query the NPDB regarding themselves at any time.

NPDB information is not available to the general public. However, persons or entities may request information in a form that does not identify any particular entity or practitioner. Additionally, a plaintiff's attorney or a plaintiff representing himself or herself is permitted to obtain information from the NPDB under special circumstances. Defense attorneys are not permitted access to the NPDB under Title IV. However, the defendant practitioner may self-query the NPDB. Specific procedures for attorney requests are identified in the Fact Sheet for Attorneys.

Confidentiality of NPDB Information

Information reported to the NPDB is considered confidential and shall not be disclosed except as specified in the NPDB regulations. The Office of Inspector General (OIG), HHS, has been delegated the authority to impose civil money penalties on those who violate the confidentiality provisions of Title IV. Persons or entities that receive information from the NPDB either directly or indirectly are subject to the confidentiality provisions and the imposition of a civil money penalty if they violate those provisions. When an Authorized Agent is designated to handle NPDB queries, both the entity and the agent are required to maintain confidentiality in accordance with Title IV requirements.

The Privacy Act, 5 USC '552a, protects the contents of Federal systems of records on individuals, like those contained in the NPDB, from disclosure without the individual's consent, unless the disclosure is for a routine use of the system of records as published annually in the Federal Register.

The published routine uses of NPDB information do not allow disclosure to the general public. The limited access provision of the Health Care Quality Improvement Act of 1986, as amended, supersedes the disclosure requirements of the Freedom of Information Act (FOIA), 5 USC '552, as amended.

The general public may not request information from the NPDB.
Medical malpractice payers may not request information even though they are required to report.

Settlement of a medical malpractice claim may occur for a variety of reasons that do not necessarily reflect negatively on the professional competence or conduct of the physician, dentist, or other health care practitioner. Thus, a payment made in settlement of a medical malpractice action or claim shall not be construed as a presumption that medical malpractice has occurred.

Query Fees

Fees are charged for each query to the NPDB. The query fee is based on the cost of processing requests and providing information to eligible entities. Query fees cover the costs of operating the NPDB.

NPDB Help Line

For additional information, visit the NPDB web site or call the NPDB Help Line at 800-767-6732. Information Specialists are available to speak with you weekdays from 8:30 a.m. to 6:00 p.m. (5:30 p.m. on Fridays) Eastern Time. The NPDB Help Line is closed on all Federal holidays.

Courtesy Bureau of Health Professions, Health Resources and Services Administration, U. S. Department of Health and Human Services

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