1. PERFORM A SELF QUERY
A practitioner should receive notice of any reports filed, but you can check your status at any time by self-query at www.npdb-hipdb.hrsa.gov. See the NPDB guidebook (available at the same website) for simple, straightforward guidance.
2. DO NOT RESIGN CLINICAL PRIVILEGES
If you are a focus of a health care entity investigation, before you resign clinical privileges or let them expire, resolve any such investigation and confirm that no affirmative report to the NPDB will be filed against you. Get assistance from a health law attorney before any such resignation takes place. RULE OF THUMB: Department-wide investigations may be okay, but beware if any inquiry focuses on you.
3. PURSUE DUE PROCESS
Professional review actions taken by hospitals, health care entities, or professional societies that result in NPDB reports will typically allow some due process rights under the bylaws. A practitioner should access these rights to prevent a report in the first place.
4. REQUEST INPUT ON REPORT CODES AND LANGUAGE
If a healthcare entity notifies you of a report before filing, request input so that the report reflects a reasonable, truthful, and (perhaps) a more benign version of the events.
5. IMMEDIATELY REBUT
Once a report is filed, it can be accessed by certain health care entities, so a practitioner should submit an immediate rebuttal. The rebuttal (limited to 4,000 characters, including spaces) should concisely and objectively explain the reported event and relevant external factors.
6. ATTEMPT TO RESOLVE DISPUTE DIRECTLY
Before a report can be formally disputed with the NPDB, a practitioner must attempt to resolve the dispute directly with the reporting entity. If the reporting entity agrees, it can voluntarily void, revise, or correct the report.
7. ELEVATE DISPUTE FOR NPDB SECRETARIAL REVIEW
A practitioner can request administrative review by marking the report “disputed” when submitting a rebuttal through www.npdb-hipdb.hrsa.gov. By written submission process, the language of the report will be reviewed for factual accuracy as well as whether the report was required, but will not address the propriety of underlying action.
8. JUDICIAL REVIEW AVAILABLE BUT NOT INJUNCTIVE RELIEF
A practitioner can file suit under the federal Administrative Procedure Act but a reviewing court cannot substitute its judgment for the NPDB’s review, and will reverse only when the decision is shown to be arbitrary, capricious, and having no rational basis. Rarely do such lawsuits have any success. Courts usually reject injunctive relief.
9. IMMUNITY EXISTS EXCEPT FOR KNOWINGLY FALSE REPORTS
Federal law provides legal immunity for reporting entities except when the report can be proven false and made with knowledge of the falsity. Wording of the reports by health care entity’s counsel (“suspension was imposed due to concerns that . . .”) will typically make a successful defamation suit impossible.
10. STAKES ARE HIGH SO GET LEGAL HELP IMMEDIATELY
Help from an attorney versed in NPDB and other reporting requirements under state and federal law is crucial given that a NPDB report usually remains on record indefinitely. Attack a report early on instead of waiting for the effects of the report, which may include inquiries from state boards, hospitals, health care entities, and insurance providers, as well as possible adverse action.