National Practitioner Data Bank
In many cases, a medical malpractice settlement or verdict must be reported to the National Practitioner Data Bank (NPDB). However, the responsibility to report does not typically fall on the doctor personally, but rather on the malpractice insurance carrier or the entity that made the payment, such as a hospital or medical group.
The NPDB is a confidential federal database maintained by the U.S. Department of Health and Human Services. It was created to track malpractice payments and disciplinary actions across state lines and ensure that hospitals, medical boards, and licensing authorities have access to a provider’s history of professional conduct.
Who Is Required to Report to the NPDB?
Under federal law, the following entities are required to report to the NPDB:
- Malpractice insurers that pay a claim on behalf of a provider
- Hospitals and healthcare entities that restrict or revoke clinical privileges for more than 30 days
- State licensing boards that discipline a provider
- Professional societies that take adverse actions based on competence or conduct
Individual doctors are not required to self-report settlements or judgments, although they are made aware of the report filed on their behalf and are allowed to submit a statement in response.
What Triggers an NPDB Report?
An NPDB report must be filed when:
- A payment is made on behalf of a physician, dentist, or other licensed healthcare provider to resolve a written claim or lawsuit of medical malpractice
- The claim involves alleged acts or omissions in the provision of health care
- The payment is made on behalf of the provider, even if the provider denies wrongdoing
This means that even if the provider is not found liable, a settlement alone is enough to trigger a report if it resolves a claim made against them.
Example: If a doctor is sued for delayed cancer diagnosis and the case settles for $750,000—without any admission of fault—the insurance company must still report the payment to the NPDB.
Will This Affect the Doctor’s Medical License?
Not directly.
While all malpractice settlements and verdicts paid on behalf of a licensed provider are reported to the NPDB, these reports do not automatically lead to license suspension or disciplinary action.
However, state licensing boards, hospitals, and credentialing bodies regularly review a provider’s NPDB file when considering:
- License renewals
- Hospital privileges
- Employment or partnership opportunities
- Insurance panel participation
A single report is often not enough to result in formal discipline. But multiple malpractice payments, particularly in a short time span, may trigger closer scrutiny or further investigation by a state medical board.
Is the NPDB Public?
No. The NPDB is not open to the public, and patients cannot search it directly. Access is limited to:
- State licensing boards
- Hospital credentialing committees
- Health insurers and HMOs (under limited circumstances)
- Federal and state law enforcement agencies
However, many states—including Pennsylvania—require that certain malpractice payments or disciplinary actions be disclosed to the public through state medical board websites, so some related information may be available via those channels.
Can a Doctor Dispute an NPDB Report?
Yes. A physician who is the subject of an NPDB report has the right to:
- Review the report
- Submit a written statement of explanation for inclusion in the file
- Initiate a dispute resolution process if they believe the report contains inaccurate or inappropriate information
Still, the fact of a malpractice payment itself is not something that can be erased simply because the doctor disagrees with the claim.
Summary: Reporting to the NPDB and What It Means
- Yes, malpractice settlements and verdicts are usually reported to the NPDB.
- No, this does not mean the doctor loses their license.
- The report is confidential, but available to hospitals, licensing boards, and credentialing entities.
- A report may affect a provider’s future job prospects or privileges, especially if there’s a pattern of claims.
- The provider can respond to the report, but cannot block it if the payment was made on their behalf.