Reporting Medical Malpractice Payments To The NPDB

The stated reasons behind the law that created the National Practitioner Data Bank were the increasing incidents of medical malpractice litigation and the need to improve the quality of medical care that became a national problem that required greater efforts than could be undertaken by the individual States. It was hoped that effective professional peer review could restrict the ability of incompetent practitioners from moving from one State to another without them disclosing or others discovering previous incompetent performance.

Each entity that makes a payment for the benefit of a physician, dentist, or other health care practitioner in settlement of, or in satisfaction in whole or in part of, a claim or judgment against that practitioner must report the payment information to the National Practitioner Data Bank (NPDB). A payment made as a result of a suit or claim solely against an entity (a hospital, clinic, or group practice) and that does not identify an individual practitioner is not reportable under current regulations of the NPDB. (This loophole is often used by the lawyers for medical malpractice defendants. Because medical malpractice plaintiffs often name the individual health care provider as well as his/her group practice and/or the medical facility at which he/she was practicing at the time of the alleged medical malpractice error as the defendants in a lawsuit or formal written medical malpractice claim, the medical malpractice defendants’ lawyers often require that the individually named medical malpractice defendant be dismissed from the lawsuit or claim so that any payment that may result from a settlement or judgment payment will not have to be reported to the NPDB.)

The entities that are required to file reports with the NPBD must report when a lump sum payment is made or when the first of multiple payments is made. Medical malpractice payments are limited to payment of money and must be the result of a written complaint or claim demanding payment for damages. The written complaint must be based on a practitioner’s provision of or a failure to provide health care services. A written complaint or claim can include, but is not limited to, the filing of a cause of action based on the law of tort in any State or Federal court or other adjudicative body, such as a claims arbitration board.

Reports must be submitted to the NPDB and the appropriate State licensing boards within 30 days of the date that a payment is made (the date of the payment check). The report must be submitted regardless of whether the payment was made as a result of a matter settled out-of-court, in payment of a judgment, or in satisfaction of an arbitration award. The 30-day period begins on the day following the date of payment.

The law provides that a payment in settlement of a medical malpractice action or claim is not construed as creating a presumption that medical malpractice has occurred.


When medical malpractice errors have caused serious personal injuries or death, you should promptly consult with a medical malpractice lawyer regarding your legal rights to bring a claim for medical malpractice and to receive compensation for your losses and injuries. Visit our website to be connected with local medical malpractice lawyers who may be able to assist you with your potential medical malpractice claim or call us toll free at 800-295-3959.

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This entry was posted on Saturday, September 10th, 2011 at 1:55 pm. Both comments and pings are currently closed.


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