The National Practitioner Data Bank published an updated NPDB Guidebook on October 26, 2018.  It can be found online at:

https://www.npdb.hrsa.gov/resources/aboutGuidebooks.jsp

The update provides specific guidance on reporting adverse professional review action. Under prior guidelines, many entities interpreted a voluntary leave of absence, or an agreement to refrain from practice, during an investigation, as a nonreportable event.  The new guidance suggests that these arrangements may be reportable depending on the length of time the actions are in effect.  Similarly, a quality improvement plan may be reportable if it extends beyond a thirty-day provisional review period and may be considered an “investigation” if the practitioner resigns while the plan is in place. The update clarifies that a resignation or lapse in privileges, while the provider is under review for reappointment, may also be reportable when the credentialing staff is reviewing a concern relating to the provider’s professional competence or professional conduct.

With these changes, it appears that the NPDB intended to eliminate any previous misperceptions regarding certain reporting obligations. These changes therefore warrant careful analysis by reporting entities.

This new guidance will significantly impact health care providers and facilities navigating the complex world of medical staff credentialing and reporting.  It is important to review the medical staff bylaws under which you or your facility operate to assure ongoing compliance with both federal and state law.  Caplan and Earnest would be happy to provide more information or updated training to you and/or your medical staff on these new guidelines.  Please contact a member of our Health Law team at (303) 443-8010.