KMRRRG understands concerns related to settlement of claims and malpractice payment recording requirements under the Health Care Quality Improvement Act of 1986, better known as the National Practitioner Data Bank (NPDB). In an attempt to address common potential concerns and to outline the intent of reporting, to follow we present our response to several frequently asked questions. If your questions or concerns remain unresolved, please feel free to contact our office to discuss reporting requirements in further detail. 
 
Q: Why is my malpractice insurance carrier required to report settlements to the NPDB and what is the intent of the Health Care Quality Improvement Act (HCQIA)?
A:  Congress enacted the HCQIA to prevent malpractice, to improve the quality of care and to ensure that incompetent physicians could not move from state to state without disclosure of or the potential to discover his/her previous damaging or incompetent performance. The NPDB is primarily an alert or flagging system.

Q: Who has access to reports made to the NPDB?
A: The federal Privacy Act protects the contents of the NPDB from disclosure to the general public. Section 11137(b)(1) of the HCQIA outlines the confidentiality of the information reported and prevents disclosure other than to the physician or provider involved, except to hospitals seeking information related to physicians seeking privileges in fulfillment of the healthcare entities' legal obligation. The data bank is prohibited by law from disclosing information on a specific practitioner, provider, or supplier to a member of the general public. However, persons or organizations can request information in a form that does not identify any particular organization or practitioner by registering with the data bank to access their public use data file. The public use data file is designed to provide data for statistical analysis only.
 
Q: How do I avoid being reporting reported to the NPDB?
A: First and foremost, practice safe medicine and avoid claims. KMRRRG provides aggressive defense for every claim, generally restricting claims resolution to those that involve a deviation from the standard of care.
 
Q: If I am named as a defendant in a formal complaint, am I automatically reported?
A: No. However, if a settlement payment is made on your behalf to satisfy the resolution of a claim or judgment, a report must be filed.
 
Q: What if I decide to pay a nuisance value to resolve a claim?
A: Reporting is still required. However, the Secretary of Health and Human Services understands that some claims may be resolved for a variety of reasons, and are not a reflection of the professional competence or professional conduct of the provider.
 
Q: When should I refuse settlement to avoid reporting to the NPDB?
A: KMRRRG prepares an aggressive defense for all claims and does not settle claims without detailed discussions with you and your defense counsel. However, we do encounter claims that represent a clear deviation from the standard of care. It is not recommended that cases continue for which no expert can be retained to defend the care provided. Therefore, it is not recommended that reporting to the NPDB be used as the pivotal decision point in how to resolve a claim. Refusing to resolve an indefensible claim to avoid reporting could place you at risk for an excess verdict.
 
Q: Where can I get additional information?
A:  Please contact our office at 502.569.2060 or logon to http://www.npdbhipdb.hrsa.gov.