National Practitioner Data Bank Updates Guidebook

Last Updated: Jan 31, 2019

keyboard-stethoscopeThe National Practitioner Data Bank (NPDB) has updated its guidebook. The NPDB Guidebook is updated periodically. Prior to the latest revisions, the last update was in April 2015.

These new updates were issued without notice. Access the updated NPDB Guidebook here. 

What Are These Updates?

New updates to the NPDB Guidebook include the following:

  • Length of Restriction. A new section titled “Length of Restriction” is included under Chapter E: Reports. This section clarifies that entities must report adverse clinical privilege actions to the NPDB if they result from a professional review action and last longer than 30 days, regardless of how the restriction was written.
  • Surrender of Privileges While Under Investigation. The NPDB regulations (see 45 CFR §60.12) state that any surrender or voluntary restriction of clinical privileges while under investigation, relating to professional incompetence or improper conduct, must be reported. The latest updates to the NPDB Guidebook include new questions that address this reporting requirement. These questions clarify that agreements not to exercise privileges and leaves of absence that restrict privileges while under investigation must be reported to the NPDB. Also, a practitioner’s withdrawal of a pending reappointment application could also be reportable to the NPDB if review of the application had deviated from routine review of such applications.
  • Quality Improvement Plans. The updates to the NPDB Guidebook also explain that resignation while a practitioner is subject to a “quality improvement plan” may be reportable to the NPDB depending on the requirements of the plan. The plan could be considered an investigation. For example, if the plan is focused on one practitioner for competency concerns and if such plans typically lead to a professional review action, the plan would be considered an investigation by the NPDB. A physician’s resignation or surrender of privileges while under an investigation must be reported to the NPDB. Also, if the plan restricts a practitioner's clinical privileges and was the result of a professional review action, that concerned the practitioner's professional competence or conduct, and is in place longer than 30 days, the plan itself would be a reportable clinical privilege restriction.
  • Private Agreements. The NPDB clarified that if a state licensing or certification board takes an adverse action that is the result of a formal proceeding, it must be reported even if the action was taken through a private agreement. Adverse actions by state boards need not be publicly available to be reported.

Where Can I Find Additional Information?

Pursuant to policy passed at the Pennsylvania Medical Society’s (PAMED) October 2017 House of Delegates, PAMED opposes any use of the NPDB to manipulate or dissuade physicians from application and participation on medical staffs.

It is imperative that physicians understand when they can be reported and what to do if reported to the NPDB. PAMED has the following educational resources on the NPDB for physicians:

PAMED members with questions can contact our Knowledge Center at 855-PAMED4U (855-726-3348) or        

Login to be able to comment

Leave a comment

Norcal Mutual

Learn More