Data Bank Basics

Whether you realize it or not, you as a health care organization representative or a medical practitioner are directly affected by what is called the “Data Bank.” As part of the U.S. Department of Health and Human Services, the Data Bank is a confidential information clearinghouse created by Congress in order to “improve health care quality, protect the public and reduce health care fraud and abuse in the U.S.” Established in 1986, the Data Bank is made up of the National Practitioner Data Bank (NPDB) and the Healthcare Integrity and Protection Data Bank (HIPDB) and is responsible for collecting and distributing reports containing the negative actions of a physician.

Before we go any farther, we must say that there’s no need to panic. If you’re just hearing about this now, let us assure you that the information is not public and can only be obtained by authorized personnel such as government officials, health care facilities, hospitals, attorneys and select other approved agencies. The records may be released to public viewers, but it will not contain the physician’s identity or specific information.

The Data Bank is primarily used to inform health care organizations such as hospitals, health plans and regulatory entities to conduct an in-depth review of a practitioner’s past actions before entering into partnership with, referring or recommending the physician. The information available in each report includes a variety of information regarding a care-provider’s history including medical malpractice payments, adverse licensure actions, negative peer reviews, civil judgments, criminal convictions, license/certification suspensions and other actions that are deemed negative. In keeping the records, the Data Bank relies on the reporting of a number of entities involved in each case. Those who can submit reports include medical malpractice payers, state authorities, hospitals, formal peer review organizations, government agencies, health plans, licensing groups and private accreditation organizations.

The good news is that the Data Bank remains committed to serving both the health care organizations and the practitioners. Whenever a report is filed on a practitioner, he or she has a chance to view the information, review it for accuracy, and submit details regarding their side of the story. According to the Data Bank, it sees its overall goal as improving the quality of health care, which, many times, will involve the viewpoint and rebuttal of the defending practitioner.

The process of a report begins when an organization sends information to the Data Bank, which in turn processes the data and sends a copy of it to the reporting party. The Data Bank also sends a notification to the affected practitioner, who then can review the report for accuracy. Once the report has been officially filed, the practitioner can respond to it either by adding a statement or disputing its factual accuracy. In a last resort, the physician my also request a report review as a way of combating the file.

Any practitioner who has been involved in a malpractice case, license issue or other negative claim can find out if they are listed in the Data Bank by conducting a self-query through the Data Bank’s website. And, as medical malpractice attorneys, we at Gutglass, Erickson, Bonville & Larson encourage all practitioners to search the Data Bank for any reports that list them in order to be sure the records are accurate. Should any false or inconspicuous information be found and legal representation is needed, that practitioner should contact us right away. After all, reputation as a quality health care provider is crucial to a career, and physicians need to do whatever they can to protect it.

For a free case evaluation or to request legal assistance, contact Gutglass, Erickson, Bonville & Larson today!  

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