What is the National Practitioner Data Bank?
The National Practitioner Data Bank (NPDB) is a confidential, web-based repository operated by the U.S. Department of Health and Human Services (HHS). It collects and discloses reports on medical malpractice payments and certain adverse actions (such as licensure disciplinary actions, clinical privilege restrictions, professional society actions, and exclusions from federal programs) involving health care practitioners, providers, and suppliers.
Established by Congress under the Health Care Quality Improvement Act of 1986 (with later expansions, including the merger of the Healthcare Integrity and Protection Data Bank in 2013), the NPDB aims to improve health care quality, protect the public, and reduce fraud and abuse by serving as a flagging system for professional competence and conduct issues.
Information in the NPDB is not publicly available and can only be accessed by authorized entities (e.g., hospitals, state licensing boards, and certain health care organizations) for credentialing and review purposes. Practitioners can self-query their own records. Once a negative entry is entered into the NPDB it is difficult to remove but it can be updated.
What Information Does It Contain?
The NPDB does not contain "good" news or general credentials; it specifically tracks adverse actions and medical malpractice history, including:
Medical Malpractice Payments: Details on any exchange of money resulting from a written claim or judgment against a practitioner.
Adverse Actions: Revocations, suspensions, or reprimands of a professional license by state boards.
Clinical Privilege Actions: When a hospital or healthcare entity limits, suspends, or revokes a doctor’s privileges for more than 30 days due to professional competence or conduct.
Professional Society Actions: Reductions in membership status based on peer review of a practitioner's conduct.
Criminal Convictions/Civil Judgments: Healthcare-related legal actions or exclusions from federal programs like Medicare and Medicaid.
2. Who Can Access the Data?
The NPDB is not available to the general public. Because it contains sensitive and sometimes unproven allegations (like pending malpractice settlements), access is strictly regulated:
Eligible Entities: Hospitals, state licensing boards, health plans, and other professional peer-review bodies are required or permitted to "query" (search) the database.
Self-Query: Individual practitioners (doctors, nurses, dentists, etc.) can request a "Self-Query" to see what information, if any, is stored about them.
Attorneys: In very limited circumstances, a plaintiff's attorney may gain access if they are suing a hospital that failed to check the NPDB for a specific practitioner
For more details, visit the official site at NPDB Website.
When our attorneys are asked whether an entry can be removed or corrected the answer is "yes" in theory but most always "no" unless the error was in good faith (rare -most entries are retaliatory), or a judicial decision found no basis for the false entry.
You can view the rules in detail at the NPDB website but the outline is this.
The NPDB itself does not have the legal authority to change or remove a report on its own; only the reporting entity (e.g., a hospital, insurance company, or state board) or the U.S. Department of Health and Human Services (HHS) can do so.
Here is the breakdown of how the process works:
1. The Direct Approach: Correction or Voiding
The fastest way to resolve an error is to work directly with the organization that submitted the report.
Correction Report: If the report has minor factual errors (like a wrong date or misspelled name), the entity can submit a Correction Report, which replaces the old one.
Void Report: If the report should never have been filed (e.g., the action was overturned on appeal or it didn't meet reporting requirements), the entity can "void" it. A voided report is removed from your disclosable record entirely.
2. The Dispute Process
If the reporting entity refuses to fix the error, you can initiate a formal dispute through the NPDB:
Dispute Status: You can sign into your report and place it in "Dispute Status." This adds a notification to the report so that anyone who queries it sees that the accuracy is being challenged.
Subject Statement: You can add a statement (up to 4,000 characters) to the report at any time. This allows you to explain your side of the story to future employers or credentialing boards while the dispute is pending.
3. Elevating to "Dispute Resolution"
If you cannot reach an agreement with the reporting entity after 60 days, you can request that the Secretary of HHS review the case.
Important Limitation: HHS will only review if the report is factually accurate based on the reporting entity's written record and if it was legally reportable. They will not review the "merits" of the case (e.g., whether the hospital's underlying decision to discipline you was fair).
So even though the rules allow for correction, removal or updating it is a rigged contest between the individual doctor and a well funded hospital (or physicians group). In addition, the fact that you are at the NPDB level in your dispute shows that there more problems down the line. If you need the advice from our medical law team call to set up an initial consultation. (925) 283-1863
