If you're a healthcare professional facing disciplinary action against your license, the repercussions can reach far beyond your immediate situation. Getting back on your feet is not as easy as simply moving to another state and applying for licensure because those adverse actions follow you wherever you go. That's thanks to a law passed by Congress in 1986 known as the Healthcare Quality Improvement Act (HCQIA) and the subsequent creation of the National Practitioner Data Bank (NPDB). This database provides regulatory agencies with information about medical practitioners and organizations, allowing them to make informed decisions about licensure and other matters related to the healthcare industry. If you're a doctor, dentist, or another practitioner, and if you've had any kind of adverse action taken against you professionally, it's important to understand how the NPDB works and how it can affect your license to practice. Let's take a closer look.

What Is the NPDB?

The NPDB is a confidential information clearinghouse created by the NCQIA. It collects data on medical malpractice payments, disciplinary actions taken against healthcare professionals, license revocations or suspensions, and other information relevant to the regulation of healthcare professionals. This database was created to prevent healthcare practitioners from moving from state to state or between facilities without disclosing or being held accountable for any damaging performances they may have had. Regulatory agencies use this data to verify that licensed practitioners meet state requirements for licensure and renewal. Hospitals and other healthcare employers can also access the NPDB to perform authorized peer reviews on staff members and candidates for employment.

What Is the HCQIA?

The Healthcare Quality Improvement Act (HCQIA) of 1986 was designed to encourage healthcare organizations to participate in peer review activities by protecting them from liability if they report or act on information obtained during the course of a peer review. It also requires that certain actions be taken into account when evaluating a practitioner's qualifications for licensure, including any reports or other information filed by hospitals, professional societies, and state licensing boards. This means that any adverse actions taken against a healthcare practitioner must be reported to the NPDB in order for regulators to consider them when evaluating licensure applications. It also means that as a healthcare practitioner, you aren't allowed to sue these entities for looking up your NPDB report and making decisions regarding your licensure or employment based on what information is reported there.

How Can the NPDB Affect My License?

If you are a licensed healthcare professional, it's important to be aware of the implications of having your name appear in the NPDB. For example, if you have been disciplined by your state licensing board or were the defendant in a medical malpractice suit, this information will be reported in the NPDB and available for review by any other agency that has access to this information. This means that even if you have never had any issues with your license before, having your name appear in the NPDB could seriously impact your ability to get or keep a license in another state.

What Should I Do If My Name Appears In The Database?

You have the right to do a self-query with the NPDB to see whether any adverse actions have been reported against you. If your name appears in the database and you believe there is an error or omission, you can file an appeal with either your state licensing board or directly with the U.S. Department of Health and Human Services (HHS). Depending on what type of issue it is related to, HHS may review the report and determine whether any changes need to be made. However, it is important to note that appeals can take time, so if you are facing imminent action from a licensing board due to something appearing in your NPDB record, it is best to contact an attorney right away so they can help protect your rights as soon as possible.

An Ounce of Prevention

Of course, the best way to avoid having negative repercussions due to the NPDB is to take all necessary steps to make sure there's no reason to generate a report about you. If you've been accused of professional misconduct and are under investigation by your state licensing board, an experienced professional license defense attorney can work on your behalf to protect your record and your good name. Attorney Joseph D. Lento and his Professional License Defense Team have nationwide experience assisting doctors, nurses, dentists, and other licensed professionals who are facing possible adverse actions from their licensing boards. Call the Lento Law Firm at 888-535-3686 today to schedule a consultation.