Jason Brodsky: Welcome. My name is Jason Brodsky and I'm joined by my colleague, Andy Jordan. Thank you for tuning in. On behalf of the division of National Practitioner databank.
Jason Brodsky: We are delighted to have the opportunity to present information to you about the Federal Tort Claims Act and the National Practitioner Data Bank.
Jason Brodsky: Working together to support quality care and patient safety. Our presentation will describe the mission of the National Practitioner Data Bank.
Jason Brodsky: FTCA deeming requirements involving the use of the NPDB use of agents, our attestation initiative and where you can find additional resources. Next slide please.
Jason Brodsky: National Practitioner Data Bank was established in 1986 out of a concern that healthcare entities needed more information to make informed hiring licensing.
Jason Brodsky: And credentialing of healthcare practitioners at the time. If a practitioner did something wrong he or she just would pick up and move to another state.
Jason Brodsky: And there was no way for a future employee or state medical board to find out about the previous situation.
Jason Brodsky: Congress created the National Practitioner Data Bank to be a workforce tool. It is a central place where information on practitioners is stored and can be accessed by healthcare organizations, making hiring and credentialing decisions. Next slide please.
Andy Jordan: Thank you, Jason, for that introduction. The reason we're here today is to emphasize the links between the FTCA program and the NPDB
Andy Jordan: The Health Center Program and FTCA requirements are similar regarding credentialing and privileging
Andy Jordan: It's both Health Center Program policy as well as FTCA program deeming that require querying the NPDB.
Andy Jordan: This requirement can be found in the HCP compliance manual chapter five and in the annual FTCA deeming application here you can see excerpts from the deeming application that is a document that's on the slide.
Andy Jordan: Next slide please.
Jason Brodsky: When you are considering hiring or credentialing new clinician, you would want to know what kind of information, if any, has been reported to the NPDB. We call that query.
Jason Brodsky: When you query the NPDB, there is a lot of information available to your organization. To get an idea about how valuable the NPDB is as a workforce tool here you see some numbers.
Jason Brodsky: NPDB contains more than 1.3 million reports. Every month, the NPDB is queried more than 640,000 times by healthcare entities across the country.
Jason Brodsky: On average, state agencies, malpractice pairs and healthcare entities submit more than 7,800 reports every month.
Jason Brodsky: And there are more than 670,000 practitioners and more than 24,000 organizations represented among the reports in the National Practitioner Data Bank.
Jason Brodsky: On this slide, it shows the kind of reports that are contained in the NPDB: adverse action reports, medical malpractice reports, and judgments or conviction reports. Next slide please.
Andy Jordan: As told earlier, health centers are required to query the NPDB. So it's not just the NPDB legislative requirements that are important to you.
Andy Jordan: Health centers have to have credentialing and privileging processes in place for initial hires and subsequent bi-annual reviews.
Andy Jordan: This process includes the requirements to complete a query through the NPDB. This is an excerpt from the compliance manual and there's a link to the specific chapter
Andy Jordan: Also, you can query on a wide range of practitioners
Andy Jordan: That are called licensed independent practitioners or other licensed and certified practitioners here. We have 17 specific professions and others that are included in our reports on the
Andy Jordan: HRSA Data Warehouse. To give you an idea of the kinds of professions are included, almost anything you can think of, a wide range of behavioral health as well as pretty much optometrists and almost anything else you can think of. So it's a lot of information there.
Andy Jordan: Next slide please.
Andy Jordan: What queries required in specific circumstances by the Health Center Program, health centers may query for all of the following reasons:
Andy Jordan: When they have or maybe entering into an employment or affiliation relationship with health care practitioner.
Andy Jordan: When practitioners apply for clinical privileges or medical staff appointments; when they are engaging and professional activity with a practitioner; or when a practitioner asks for expanded or additional privileges.
Andy Jordan: When a health center is credentialing a practitioner or renewing practitioners' credentials. So all those are times that you can do querying.
Andy Jordan: When a health center query the NPDB, it will get a lot of information.
Andy Jordan: Medical malpractice payment information, licensure actions by states, adverse actions taken against [inaudible] who is by other entities and a lot more, but it's also important to note that you may not get any information.
Andy Jordan: 95% of queries receive No Reports Found response and that's good news. But this information is also beneficial in your decision making process.
Andy Jordan: As most of you know, querying is not free, it costs your organization $2.
Andy Jordan: Self queries by practitioners, which is when they asked for a copy of their reports on them, which they then provide to potential employers, costs $4. It's important to note that self querying is not allowed under the health center policy. The entity must do the querying, not the practitioner.
Andy Jordan: Next slide please.
Jason Brodsky: So how do I query? There are two ways to query the National Practitioner Data Bank.
Jason Brodsky: There is a continuous query, for what you can enroll practitioners and receive information that the National Practitioner databank may receive on them during the one year enrollment period.
Jason Brodsky: You can also do what's called a one time query, in which you submit a request for an individual practitioner and receive only what's available on that person at that time. The fee is the same, two dollars. Next slide please.
Andy Jordan: Great. That takes care of querying responsibilities for health centers. Now I want to talk about reporting.
Andy Jordan: This slide includes the key language from the NPDB regulations and language from our website regarding reporting.
Andy Jordan: If you meet the definition as an entity that engages in professional review activity, you are required to report certain actions taken against physicians and dentists.
Andy Jordan: These are clinical privileging actions that last more than 30 days. The key reason for reporting, other than the legal requirements, is that without reports, querying is not very effective.
Andy Jordan: If nothing is in the Data Bank, you can't get anything out of it when you query it. In addition, the FTCA manual is a good resource as well.
Andy Jordan: Section two, part one, on malpractice payments and immunity and part M on the medical claims review panel role in reviewing payments both reference
Andy Jordan: reporting to the NPDB. So it is important for health centers to report. Here's some additional statistics on the kinds of reports that are in the NPDB.
Andy Jordan: state licensure reports make up 55% of all the reports in the Data Bank; malpractice payments, 29%; exclusions and debarments, 8%;
Andy Jordan: judgments and convictions, government administrative actions, clinical privilege actions, 2%;
Andy Jordan: Health Plans 1%, and minimum amount of DEA or Federal licensure reports, professional society actions or accreditation. That tells you a little bit about what's in the Data Bank. The kind of things you will find. Next slide please.
Jason Brodsky: So why is reporting important to health centers and their patients? As Andy mentioned before, querying is only as good as the quality and quantity of reports submitted.
Jason Brodsky: Since providers often move to other similar settings or practices, reporting by one health center can protect other health centers and their patients. Next slide please.
Andy Jordan: So what should be reported by health centers? As mentioned earlier, physicians and dentists must be reported for professional review actions that impact clinical privileges for more than 30 days. Next slide please.
Andy Jordan: Also, reporting should be done for cases where a practitioner surrenders their privileges while under investigation.
Andy Jordan: If you've initiated investigation on someone and they say, "okay, nevermind, I'm just going to leave," that needs to be reported. That's very important information to include as well. Next slide please.
Andy Jordan: Reporting of other professionals beyond physicians and dentists is not required, but is strongly encouraged.
Andy Jordan: Health Centers and other entities employ a wide variety of professionals and the more information you can get on people when you're looking to hire them, it's important. So you could also report on those professionals as well. Next slide please.
Jason Brodsky: Many organizations use agents for querying and or reporting. It's important to note that agents must be registered as well, even if the agent is doing the reporting and query to receive information on queries. Next slide please.
Andy Jordan: Now we want to review the role of attestation for health centers. Attestation is the process that has become part of the registration renewal process that takes place every two years.
Andy Jordan: So every two years, you'll be asked about the attestation for [inaudible] I give you a little bit of information
Andy Jordan: about it. It has two goals: to ensure the accuracy and completeness of the information in the NPDB and to help educate users about their reporting obligations.
Andy Jordan: Most entities very only occasionally report. Health centers, in general, have very few reports in the Data Bank. So it's difficult to remember all the ins and outs of reporting and what's required.
Andy Jordan: Attestation is an opportunity for entities to look at their reporting requirements and make sure they understand what they are and whether they're meeting them.
Andy Jordan: The benefits of querying are only as good as a quality information available from reports so complete reporting is critical.
Andy Jordan: For some background, in 2010 the NPDB began a compliance process with state boards, which included attestation, was very successful.
Andy Jordan: In increasing the number of reports that were submitted that were required and hadn't been submitted previously.
Andy Jordan: And bringing the boards into compliance with their reporting. So we've expanded the attestation initiative to all entities now currently registered with the Data Bank.
Andy Jordan: Health centers and hospitals were the next two organizations that were rolled out, but now everyone is part of the attestation process. Next slide please.
Andy Jordan: What is attestation? As I said, it's a compliance initiative to assure the most complete data on healthcare practitioners and entities.
Andy Jordan: Are available for querying and we basically ask you when you're registering and renewing your registration to assert that you've reported
Andy Jordan: All the things that you are required to report during that previous two year period.
Andy Jordan: At the same time, health centers will get a listing of sites that are included within their scope of projects. We want to make sure that
Andy Jordan: All of the organizations that are involved in your credentialing and privileging process are included in our information.
Andy Jordan: On we have about, probably 95% of them, are accurate. Occasionally people add a site or delete one because there's delays in the EHB information that we get. So you'll get that as well in the attestation process. Next slide please.
Jason Brodsky: There are a lot of resources available that explain the attestation process and purpose in more detail. The NPDB website, pictured here, has a wealth of information.
Jason Brodsky: The red circle on the bottom is a link to your organization where you can select health centers and see what the red arrow is showing you. That will direct you to the specific health center attestation page. Next slide please.
Jason Brodsky: So where can you get more information? Well, BPHC has resources on risk management and NPDB has a number of resources on querying and reporting. Next slide please.
Jason Brodsky: Here are some NPDB resources. If you have specific questions, please contact our customer service center. The hours of the customer service center are
Jason Brodsky: Monday through Thursday 8:30am to 6pm and Friday 8:30am to 5:30pm. You may also at anytime, of course, send an email to the address listed here.
Jason Brodsky: We are also encouraging all of our organizations to complete our survey so we can assess the characteristics of and generate comprehensive knowledge about users of the National Practitioner Data Bank. This will help us improve our processes and systems.
Jason Brodsky: The survey will be open between May and June of 2021. A link will be sent to users via email or secure message. Your feedback is essential to improving NPDB as we seek to improve health care quality. Next slide please.
Jason Brodsky: I'd like to take a moment to remind everybody of some important dates: on April 19, at midnight, the EHB system will be closed to transition to the new FTCA applications.
Jason Brodsky: On April 23, EHB opens to accept health center redeeming and initial applications. VHP redeeming initial applications can be submitted with the health center annual redeeming application.
Jason Brodsky: June 25 is when health center redeeming applications are due, and on July 15, EHB will begin accepting the VHP supplemental applications. Next slide please.
Jason Brodsky: We encourage everybody to connect with HRSA.
Jason Brodsky: at www.hrsa.gov, where you can sign up to receive our E-News. And of course, follow us on social media.
Jason Brodsky: This concludes our presentation and I want to thank you for attending this session on the National Practitioner Data Bank and we look forward to working closely with health centers and look alikes in the coming years.