National Credentialing Forum February 5, 2015 Ivy Vedamuthu U.S. Department of Health and Human Services Health Resources and Services Administration National.

National Credentialing ForumFebruary 5, 2015

Ivy VedamuthuU.S. Department of Health and Human ServicesHealth Resources and Services Administration

National Practitioner Data Bank

Presentation Overview

• Purpose• Fee Changes• System Enhancements• Research Survey• Compliance• 2015 Educational Forum• Resources• Contact Information

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Purpose

Created under three statutes to meet several needs• Flagging system for

effective credential reviews• Protection against unfit

practitioners• Deter fraud and abuse in

the health care system

Fee Changes

Fee Structure Changes

One Time $4.75 $3.00

Continuous $3.25 $3.00

Self Query $8.00 $5.00

In October 2014, users of the NPDB saved $784,000.00

System Enhancements

System Enhancements

Benefits of Moving to the Cloud• Cost Savings: Implementing the first HRSA system to move to a cloud data center will

save a significant amount of money in maintenance costs each year

• Scalability: Faster and easier adjustment to ebb and flows of use

• Faster on-screen response time: The screens load faster and the system is more responsive

System Enhancements

Field of Licensure Updates and Report Input Changes

• Some occupation titles were retired or merged, and replaced with more accurate titles

• Users may now specify an "Other Name for Occupation” in more cases

System Enhancements

QRXS Submission Duplication Checking

Many large entities use the Querying and Reporting XML Software (QRXS) to submit high-volume batch queries and reports. Occasionally, users will inadvertently submit duplicate transactions, resulting in errors or duplicate charges. New automated checks have been added to help detect and limit accidental duplicate transactions.

System Enhancements

Upcoming Changes• Re-designing the user screens for self-query, one-time query

and continuous query to make them more intuitive and require fewer steps/clicks.

• Enhancements to come in April and May of 2015

Research Survey

Research Survey

Comprehensive Survey of NPDB Eligible Users

• 13 years since last survey

• Survey response rate of 68% for organizations

• Findings reveal:

• user satisfaction with NPDB technology• user perceptions of information• impact of information on hiring, credentialing, licensing, or granting

clinical privileges to health care practitioners.

• Findings will be used to improve user experience

Compliance

Compliance

Data Bank compliance efforts over past 2 years:• Reviewed 2,154 health professions in 50 states, DC, and 5 territories (96% compliant)

• 6,505 previously missing reports submitted by entities

• 868 of those reports disclosed a total of 2,682 times

State Board Adverse Action Comparison Impact

(As of Oct. 2014)

Compliance

Physicians78,000

Dentists15,000

Physician Assistants

3,000

Advanced Practice Nurses3,000

Registered Nurses109,000

Licensed Practical/Vocational Nurses

70,000

Nurse Aides/Nursing Assistants

39,000

Social Workers3,000

Pharmacists/Pharmacy Technicians

22,000

Physical/Occupational Ther-apists/Assistants

5,000

Respiratory Therapists

2,000Other54,000

Total: ~403,000 Practitioner Reports

Approximate Number of New Data Bank Reports Submitted (Practitioners Only) From 2010 – 2013 by Profession

2015 Educational Forum

When:April 7, 2015

Where:DC Area

How:In-person only

2015 Educational Forum

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2015 Educational Forum

There are five areas of focus for attendees• Reporting to the National Practitioner Data Bank (NPDB)

• Interpreting a Query Response

• Leveraging the NPDB’s Online Research Applications

• System Updates

• The New NPDB Guidebook

2015 Educational Forum

The NPDB has created a series of four instructional videos

• Data Bank Customer Support Resource Series: Research Applications

• Data Bank Customer Support Resource Series: Reporting Adverse Licensure Actions

• Data Bank Customer Support Resource Series: Reporting Clinical Privileges Actions

• Data Bank Customer Support Resource Series: Reporting Medical Malpractice Payments

NPDB Compliance Tip Line301-945-9601

Resources

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Web Site – www.npdb.hrsa.gov– NPDB Guidebook– Interactive Training– FAQs, Brochures, and Fact Sheets– Statistics– Instructions for Reporting and Querying

Customer Service Center800-767-6732 or [email protected]

The next open enrollment period is November 15, 2014- February 15, 2015

The Health Insurance

Marketplace

www.healthcare.gov

Ivy VedamuthuDisputes Team LeadPolicy and Disputes BranchDivision of Practitioner Data BankBureau of Health WorkforceHealth Resources and Services AdministrationU.S. Department of Health and Human Services

Telephone: 301-443-9738Email: [email protected]

Contact Information

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