The National Practitioner Data Bank Updates

CHEYENNE – The National Practitioner Data Bank (NPDB) is a manual developed by the federal government to provide guidance on NPDB-related requirements.  The Guidebook was first published in 2001, and remained unchanged until 2015.  Physicians should be aware that the recent revisions to the NPDB Guidebook make several important changes to the NPDB’s interpretation of hospital’s NPDB obligations, recommending that hospitals and other reporting entities to adopt a broader definition of “investigation” in the peer-review context and to interpret any leave of absence as a “surrender of privileges.”

WMS Legal Counsel Nick Healey gave a presentation on NPDB issues last year to the Wyoming Association of Medical Staff Services, which discussed the 2015 changes to the Guidebook.  Nick’s Power Point presentation from the presentation can be viewed here.

The AMA sent a notice last week it believes these current reporting requirements may cause significant harm to physicians. For example, under the NPDB’s revised interpretation of its reporting requirements, a physician who unwittingly takes a leave of absence for health reasons during an investigation—say, a physician who takes a leave after the birth of a child—must be reported to the Data Bank, even if she was unaware of the investigation and even if she intends to request reinstatement of all privileges upon her return.

The AMA recommends that, before taking a leave of absence or otherwise surrendering any privileges, physicians should always seek to determine whether they are the subject of any investigation. Medical staffs can further safeguard their members against unnecessary and unfair reporting by adopting medical staff bylaws that:

  • Clearly define what constitutes an “investigation;”
  • Clearly define when an “investigation” begins and ends; and
  • Require that physicians be notified before the initiation of an “investigation.”

Access the AMA Physician’s Guide to Medical Staff Bylaws today for guidance, including sample bylaws language, on how to establish parameters for investigations consistent with federal law and regulations.