Our healthcare and business law firm consistently works with physicians who are dealing with complications resulting from adverse reporting to the National Practitioner Data Bank (“NPDB”). Certain entities, including medical licensure boards, facilities with a peer review process, and medical malpractice payers, have a duty to report specific actions or events to the NPDB. Any practitioner who has had the misfortune of having an action reported to the NPDB is likely aware of the negative impact such a report can have on his or her ability to practice. Sometimes, however, the information reported to the NPDB is inaccurate in whole or in part or, even if accurate, inappropriately reported. Inaccurate or inappropriate reports can have equally serious adverse impacts on a medical provider’s ability to practice as any correctly submitted NPDB report. This post outlines the process for disputing a report that is inaccurate or inappropriately report. If you have a question about the NPDB or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, email@example.com. You may also learn more about our law firm by visiting www.hamillittle.com.
STEP 1: Dispute the Report with the Reporting Entity
The NPDB directs providers to contact the reporting organization before initiating a formal dispute with the NPDB. Doing this is as simple as it sounds: contact the reporting entity, explain why the report is inaccurate or not reported in accordance with NPDB requirements, and request they correct or void the report. If the report is accurate, yet a new action should have also been reported, you can also request that the reporting entity file a Revision-to-Action Report. Although reporting entities have a duty to correctly report to the NPDB, entities can be sanctioned for not reporting. As such, entities have an incentive to report if there is any question as to whether reporting is required. Motivating an entity to modify a report to make it more factually accurate is a much easier feat than motivating an entity to void a report. In our experience, entities have little incentive to void a report; they would rather the provider dispute the report to HHS and have HHS direct them to void the report. Continue reading ›