NPDB

The National Practitioner Data Bank is a federal repository of reports on medical malpractice payments, adverse licensure actions, adverse clinical privilege actions, and other adjudicated actions against healthcare practitioners.

The National Practitioner Data Bank is a federal database maintained by the U.S. Department of Health and Human Services. It contains reports of adverse actions and malpractice payments involving healthcare providers. Every payer and hospital checks the NPDB during credentialing. What gets reported to the NPDB includes: malpractice payments made on your behalf regardless of whether you were found at fault, adverse licensure actions by state boards, adverse clinical privilege actions by hospitals, professional society membership actions, DEA actions, Medicare and Medicaid exclusions, and certain other negative actions. Here is the thing that catches providers off guard: even if a malpractice case was settled by your insurance company and you were never found negligent, the settlement payment gets reported to the NPDB. This is required by law. The amount of the payment and the nature of the allegation are recorded. It does not mean you did anything wrong, but it is on your record and payers will see it during credentialing. Providers cannot access the NPDB to see other providers' records. Only authorized entities like hospitals, health plans, and state licensing boards can query it. But you can request your own report through the NPDB Self-Query process. I strongly recommend doing this before you start any credentialing applications. You want to know what is on your record before a payer sees it. If you have reports on your NPDB, do not panic. Most credentialing committees understand that malpractice claims happen, especially in high-risk specialties. What matters is the pattern. One settlement from 10 years ago is very different from five claims in the last three years. Be prepared to provide a written explanation for any NPDB reports when you submit your credentialing application.