National Practitioner Database (NPDB)
On May 6, 2013, NPDB and HIPDB merged into one database referred to as NPDB.
NCSBN serves as the NPDB reporting and querying agent for the majority of the U.S. boards of nursing. The exchange of discipline information is incorporated into the function of the larger and more extensive system, Nursys.
The National Practitioner Data Bank (NPDB) is a federal data bank which was created to serve as a repository of information about health care providers in the United States. The Medicare and Medicaid Patient and Program Protection Act of 1987 led to the creation of NPDB, a data tracking system designed to protect program beneficiaries from unfit health care practitioners. The NPDB was implemented in September 1990 and required reporting of adverse licensure, hospital privilege and professional society actions against physicians and dentists related to quality of care. In addition, the NPDB tracks malpractice payments made for all health care practitioners. Proposed rules regarding adding other practitioners, including nurses to the NPDB were published in March 2007.
The Health Insurance Portability and Accountability Act of 1996 led to the creation of the Healthcare Integrity and Protection Data Bank (HIPDB). HIPDB served as a tracking system to alert users that a comprehensive review of the practitioner, provider, or supplier's past actions may be prudent. It was suggested that HIPDB’s information be used in combination with information from other sources in making determinations on employment, affiliation, certification, or licensure decisions.
Applicable federal law for the NPDB includes:
- Title IV of Public Law 99-660
- Section 1921 of the Social Security Act
- Section 1128E of the Social Security Act
On May 6, 2013, NPDB and HIPDB merged into one database – NPDB. Section 6403 of the Affordable Care Act (ACA) authorized the Secretary of the Department of Health and Human Services to cease the operation of the HIPDB and to consolidate the operation of the HIPDB with the NPDB. The goal was to eliminate duplication between the NPDB and HIPDB.
Data Bank Merger Highlights
- Reports that are currently stored in both the NPDB and HIPDB will remain, but will reside in the NPDB only
- There will be no need to re-register with the Data Bank, registration flagging systems will be automatically re-aligned
- The authority for certain reportable actions has changed, but no user action is required
- If you query both the NPDB and the HIPDB, after the merger you will only need to query the NPDB
- The new Data Bank website
Boards of Nursing Reporting Requirements
Any adverse action taken by the licensing or certification authority of the state as a result of a formal proceeding, including revocation or suspension of a license, reprimand, censure, or probation is reportable to NPDB. (78 FR 20473, Sec. 60.9) Reports must be submitted to NPDB within 30 days of the action. Complete rules, guidelines and various other resources can be found in the NPDB Guidebook. Specific questions may be forwarded to NCSBN at firstname.lastname@example.org.
Access to NPDB
Although access to information included in the NPDB is NOT available to the general public, it is available to specific entities as required by law.
Who Can Query NPDB?
- Other health care entities, with formal peer review
- Professional societies with formal peer review
- State health care practitioner licensing and certification authorities (including medical and dental boards)
- State entity licensing and certification authorities*
- Agencies or contractors administering Federal health care programs*
- State agencies administering State health care programs*
- State Medicaid Fraud Units*
- U.S. Comptroller General*
- U.S. Attorney General and other law enforcement*
- Health care practitioners (self query)
- Plaintiff's attorney/pro se plaintiffs (under limited circumstances)**
- Quality Improvement Organizations*
- Researchers (statistical data only)