When is a Doctor's Resignation Under Investigation Reportable?
A resignation while under investigation is reportable to the National Practitioner Data Bank even if the doctor was unaware of the investigation. The California Medical Board requires a report only if the doctor was aware of the investigation.
The NPDB Guidebook gives this example:
A hospital reported a clinical privileges action to the NPDB indicating that a surgeon resigned while under investigation. The surgeon objected, saying she did not know she was under investigation. She insisted that an investigation was never mentioned to her and there is no mention of investigations in the hospital bylaws. For these reasons, she said, the report should be removed from the NPDB.
Response: A hospital must submit a report to the NPDB when a physician or dentist resigns his or her clinical privileges while under investigation, regardless of whether the health care practitioner is aware of the investigation. The hospital provided documentation of an ongoing investigation at the time the surgeon resigned her clinical privileges. Therefore, the report was found to be accurate as submitted.
Under NPDB rules:
A hospital must report a resignation (or surrender) of clinical privileges to the NPDB if it occurs while the practitioner is under investigation for issues related to professional competence or conduct.
The practitioner's awareness of the investigation is not required. The report stands as long as the hospital can document that an investigation was ongoing at the time of resignation (e.g., via committee minutes, directives, or other records). Lack of mention in the bylaws or no explicit notification to the practitioner does not invalidate the report.
This rule is consistent across the NPDB Guidebook and related Q&A sections: Practitioner knowledge or formal notification is irrelevant for reporting purposes. Hospitals must provide evidence of the investigation if the report is disputed, but the absence of the practitioner's awareness does not make the report inaccurate.
Does This Apply in the Context of the Medical Board of California?
There are related but separate California-specific requirements:
California Business and Professions Code §805 (and related sections like 805.01, 805.8) requires hospitals and certain peer review bodies to file reports (often called "805 reports") with the Medical Board of California (MBC) for specific adverse actions or proposed actions involving physicians, including denials/rejections of privileges, suspensions, terminations, certain restrictions, or resignations/leaves/withdrawals after receiving notice of a pending investigation for a medical disciplinary cause or reason.
These state reports can overlap with NPDB triggers but are not identical. For example, California law sometimes ties reporting more explicitly to notice of an investigation, whereas NPDB reporting does not require the practitioner's awareness.
When a hospital files an NPDB report for a privileges action, it may also trigger or coincide with an 805 report to the MBC, and vice versa. The MBC receives many reports that are also sent to the NPDB, and disciplinary actions by the MBC itself are reported to the NPDB.
In short:
The NPDB rule (no awareness required; report if investigation was ongoing) applies fully in California for the federal data bank.
Hospitals in California must comply with both federal NPDB rules and state 805 reporting obligations, which can create parallel (but not always identical) requirements.
Navigating the peer review process and resignation rules requires expert advice and difficult judgments. The physician lawyers at the Law Office of Daniel Horowitz are here to guide you. Call us at 925-283-1863
