NEVADA STATE BOARD DENTAL EXAMINERS

NEVADA STATE BOARD

of

DENTAL EXAMINERS

LEGAL & DISCISPLINARYACTION COMMITTEE MEETING

JUNE 28, 2012

6:15 p.m.

PUBLIC COPY

REGULATORY DITTIES

≥lSSlldl1l Does 0 010,0,16000 oee’el. To, p.eI.dleo.odboeoOeorps,hOo,3113S23O1 DalyIe opn1~ pedl,ea th,d,lacrlodedod Is eso daaowe Ce doleoed,a p00,0cC or.ol,doooo,c

REPORTS

31ISSThLoo Qoos eepaess eldleelpUoaey 16050e ned ,eeldceo lObs dole, eTrLstIsl,elos

ADSIITOESSATION AND PERSONNEL

Touhelee 000eoehea; 511,000 Geseal caeleeeleed latla000 Too nhslabcoloaemeodmedbee,npEbaenooesp.doe,., beds.Coedlllee. eel lhsiloltoee awdloc eoqlosoecsl or lon000ee shone lesondale echelon l Ileoo.e

estedOCe ny hod.cicedltleoa — oah.sIoeo .ncndlnc eceoelayseoc aT peesot. rsssadtsr Weston, e.eeellse

yorlsdedb,penifie.Ccoedlooos eel OedO.elaee oepndloc 000beewla sloe potent to preside oenfra so Isdrlecsedoel

Daly ortkeo,ene.dlasOo.s ocolcie eloessoeloo necoellal laabond!cle netalisobCeelele ,odle,I hdbeesloo cod o,,a,ic p,deelelfrdladas000.leaden .TI000Iea.000eslolaoe In polo, I,eoleh eoceeIsI~ 15001 lessnlIgallaa sOb Ileeteb Insides, of

Depeoloesel efIlaith coed Oaenosessloa.looppoacabeay ‘reedde ‘ides orOptet yleollt’s lose oreslols hesonllplasy petecodlop;

opploaoulty ‘rebel peosidoe.hdl1dy1oooeedls00.Cat eel clod ,S000anl .elesseesebs Peeesl soeeoppeaotec dsetsed pINto eeesods peloes0551db I Toe 110cc rend tend by. all, ee ‘Idso sslsoosleeortcOelolaodhep,eed,aisd nodeldeneot. eealdblted,

DOellghsasy peeseeddoess Unoteco coq.afred 0 cabtede tTe0scpdlsç additinoal plants C,,dbdpnsosyaatlel.

I’) A soaomany of etach disipbeary action akron by the ronahteey body doting the istoalialety ~emolirglotIon qotodre ogeinot my Iiceo,eee ohms rngdatooy body; sod(b)Aeepeelthanioclades:

I (I)Thoatbenoflisoeseeo betot by the reyalaltey bebydoaloog the isatedialely p5,500mg taarq000eG(2)Aey’ othan isfoeesaaen dice is rejoosboni by the firestone, oh leo o’ bedy deteeseiees “aid be

bolyfst to the Legislotweisesdoaeog sohethortheatninoede.sdeemeofthere5uybodyisommsooy.2. The Disaateo thaW(C) ‘eon is atty iefoeeteloo oecemnoei poeoaaal to eaboaotion Ileeo obor of the poblie Iqtea eeqaeel(b)Ceoee .006cc oftheavailabihtyofetahisdenoeli005beyceadondopablk000fthsNeoetda

Legietalten on lie blare end(C) To emit ccompilalisa of the ieofoeotetioo received psessnel to mbeestioeo I to the Loeislelihe Ceennjoion

qtaetnly; en oso000ioe dieoolel by the Ceeeasleoie,3. The Director, en or hefete do festdey of each ongotlor tentino of the Legiotatero end no nob alas tieta en

dieealnl, ‘boll oneopilo the ropeelo otceived poeoaant to peoo~eapln (ii of eaborolmen I end diolsibele copiec of theoeeopiletmeo a the Sante Siaedis11 Ceernittee no Cneeoeron and Labor ned the Assembly elandiof Coonooineo onCeooeecn and Labor, hofsohmch shalt conic’s the ceolpaletoon to donnoojee ohclio, the conceoni collator ofaooh rc~alateey body in lecemaey.

(Added On MRS by2dSLSdl’ A 1thi&UYL’.lils 2°°’ma 2(bitII.1541)

ADMINISTRATION AND PERSONNEL

NR5622.200 Tnisloeormenhen;Aewooeycooanlcothaned000bflEtfa,nfll,loe,I. As onto en peocticabk anne eaton is fast appointod to sane as aoteonlta ofooegatatery body, elm pseson

osaonbepaesidmlsoith(,)Assoillnnooeoeaq’oftheddies — oaleraabiitim oft ocobe, ofdoregslotnzy body; ned(b) Training no these datim oral eesyoooihititian by the Afoeoey Cereal. The eaieisg most isatad’s sithaol

li,oibio~ instonatien roland 0 the atoll that ‘a required by NB21.21ds1,41th etoneyl theta pa000 shone oneanbaofdoMesada Slale Board ofAocauolaray is lot re4aiecd he he prodded asith itenctino rolaled to that ‘cdii

2. fleAt000ry Goonol osay. itaccer ecsiththepnosisisosofNtcs 220113, oberge aregntceany body forall asinine yeooided peenot It paesvspb (h) ofoabsnolino I.

(Added Ia MRS byzthjl..1131;Amiiijjjil)

NRS 622.200 Coodltlao, end litoioall001 rnEcrdlog osoeohors oh, •on too lireoceec of roostbobaty baady. Ameasbaofaregtoistarytodysolto in o000 hoatote of the reetdotery bedy ef,stdnh lot or oils isaoamotheon

I. Shallcosideiolhmatate,2. Mcd boo pason ofreeogoizel ability ned iolaooily3. Shall 001 have snbosoatiol inesseaal or foooeeisl itlmems in the pcsatiee of any ooanqtation or penfasoieo that

the roanbeony body taos the euthenity he replete or is sty ottooizathoregabsad by that regtdatoty hedy;4. Shall aol have an isooodieoe eetetios ‘she hoe oobotoooisl panted or foaooiel islands it do prelice of any

aaoapatioo or poofansion that the reedalety’ body ltas Ia oothaeily to renotate or is ntIs otttoo eat at regalstal bythan oegolotaoy helps

5, Shell not he on olTtcel booed oseesba or aoploym of a olalnair gee oaioraloogenioaisaoemahmithai ho thepopoee olodo’oceoiatg the islernets ofoo oaod,olbae pa, oesie’c’oftireooseeoeftheronalataay bodyoo nhiatt boorthe osesor seal

6. Mast rol be a eegieotod lobbyist reptesenline only iotescns or association onloting to tho portico af Myeneopaloo at ponfooloo than the rngobawny body ban the oahoasty Is notodote.

(Added to MRS by ZOOSOS2I)

NOr 122210 C,,sdill,,osos d linstloltons reEerdlog oosplos’osool or preen’ chow Itennoliole eelenh’o Isliosecee of ,nrolc000’s’ body; Rxeepo es othee,s(sa presided is MOO 1” 2100, a rerodetnoy body may 001 oeploy apasoosst,ateioeralmnerdsniveisa (aoooeeoTtheis~obtenyhady,mIeenthemgalateoybedyi,oplaoeotepoSoie,ned ptscedann In p000001 do po,taa she is aspltyed by the ensodatmoy body ftstn peotlaipatiso to nay nativitiesthen ore dieeody relateS 1° the liamsao.

(Addod be MRS by 2112.1,131)

1130 alt Rseo’o.cy ercelaoooy’a he. cod roots btecoeed by oeatdolen3 hodaol000sssl,esonletoe,p,00etdlec..3g3313.ab Oaeo~s.y oroeleooey’e fee, cod ansI, loosened byeegalaloe3 hodyboeolsiel,ocslaloe605,.

GENERAL PROVISIONS

955622.00) DefloInteoc, Ad — is thin attoplen, Iaotem — 000tnd oth,nsiee reqoisee, do nosed, ard neotndefoni is yess hI? 1120 In 022 0(d, isalosiso. baoe the macniece eweibed Is that ‘otheseamionec

Added Is MRS by 1litl_1131. 31162

Nt0562Z021 ‘lonnesllcbe IrtIlbo’ dofloosl. ‘3noo.odiaaosrlstisnt’ conesI. Aspoona2. Apaaen~ by bland, e’ eon edopoine.3. A ohitd, by blood, meerispe or edopodait.(AthsodInMISh,2jli2.bO)

NRS 021010 ‘Ilooe,e° delset ‘Liaaoe’ meats any Rcessee eeotireole regilintiR ~l no shooter loynofeathooisadoo isseod by. reeolaheny body.

(Added Ia MRS by 2160J113. 3416)

ttSOS 621040 oUoeeooe~ dolood, ‘tinoaoor” osesoe oproeno soles holds coy booboo, oasafloale, rnsieoninnretell or oimior Ispo ofoociteneiaatioe isseed by a reooteOeny bait.

(AddedboMRSby306t3Jc 3111)

90562195 ‘hbemberorc rrgolcl,,nobeds-’ doOood, ‘ldeabooofooogalatenyhody”oe.esoioeo,eonhnis000to nsa member orailloenofa orgidatony body.

(Added to 14100 by 216)11115)

NRS 622,060 °Rngalcteev hotnc’° detoed, “Reeeotttnay body’ 00015I. My state benny, teed or eaooaieoiso sobiob has tho ootheeily Is otololo so oocamss or peofmeioe

pnewentbo this 61by and2. My oltoan of o slaIn entRy, boned or eaoea,iedos ssldrh has do oathsclty lb oetsdato an oaasqtalise oe

prefaeim paensaet IC thin ice.(Added heNRI byl160ta,3djfr,A214033,13.)

REGULATORY DUTIES

NRS 621000 Daly Ia cefaree cenavlolaoc Ito heir one pn.lenIlntO cod hs000l or pablta. ho roaatetiee as,mnopetioo or ponfeedoo poessenI 10 thIs tile, shoe tory body doll sassy ml sod aifoenethe pen’ismoes of thistide fee theyerlmdoo eel boeltt ofthe eablic.

(Adthd 10MRS bylthlL°L341iI

9105 621130 Daly 55 apply gesdiog ,nnlhadolo0’ bsoI,d.d In eoctetoobino On delerletne pooclEe ofnocmlecntno. Noyoithstaasoho1 do poosisieen of my apooiftn s100atn he the cannery. if a reeaistany body, isIatirg eathanieed or ooydned pnnsaot a this dear any re5nbe.ioos edapled ~neooent theeets, aeon en onnepls araboral no ether eceadonsita allah is psodcaod oe odnoinisla,ed by en oeesnisalioo etha doe the reealolony bodyned “tech iselnedee a otadodebaoy fnrdeteoetioise the tevd olperfonsoece that coostitutone paos’eE goodeon the ooetiretioo, the regataloty holy olaoll apply thatooothodstoey in detaenmnioe ‘ohetha 0 yamS tIes 101k theaaeseieatise ochievodo passing eesda or sees

(Added Is MRS by 21117620

REPORTS

FIRS 621100 Qocnonly neponso of diedpli’csy codas, •‘d engelacorv ootinicico; dobbs eat Eteiretcor cCLegtslesice Ce,sosoe Races,

yeah ongdeoey body obal, noon before do 20th day of lessee, April. 152y and Gatabor, ethetil Is doISnostoraftheLee’alalseCoaasd ltaeraa ‘nao dmboois faeoeatpaosa,ibodbythefirndor

NRS 021230 CaldIltes, s.d lietiselta,toc rs~orclInE emplaytneol s.f poro,ao as ooeonllh’e dlesdor IT000enlh’e seceelces’ or 1° ,ltsllar pnoistan. If a reeol000ey body employs e posIts as at etcesative ditnoter onoamatistoanrtaeyorisnpodlnosaithposanoasddadeatisilmnlethseeofaao.asaetis-ediemoonorevsntio’esmrdarps the

I. ldaslposssooa cod oledtsatiaomet4aeeisoee,eroceatbioaeso of both, Ia qoabby doloasenn Ia peofoens thesdndtisntoive ard otanagaisl tade ooqtainod of the ptdlioec end

2. MauI eel be do ieoeteditte erleive af:(o)A esseberoe eltsplayee afdaroeodeoey’hodpstr(1) A hnraasee of the moollabtey body’.(Added Is MRS by 21113.1131)

NtIS 022,231 Condiectosoodltsnteoliao, reEordlng ttt0100nllsE eleh pernto II pons’tde sees-tn., cclodepseldooc anolrealon A regalataoy body soy eel cnnlJsel seith a panso In paoaido oaninoo to the moabetonyhodyoseainddqtaedattconteoatae ifthels0000iadoioaceedistemtatise of

I. A oaobermeetptnyee of Ian rr0slatary body; or2. A bisotoas nfther~elatony body, elan do oegalateoy body ieoplntoeotspsliaios aol poocalaeeabs yneveot

the paso, “ho is do isdqtoodstl onelasdaf feno palieipaierg is say oetit’iUes dol ore &ecbdy edetoi In tho

lAdded Is bilOlby 2)4*1105)

REGULATORY PROCEEDITIGSI RECORDS

MRS 022.100 Duly ofitmesro Ia dtsoboe onolalo tofonoellno regcrdtog leoeedl.te orletirsa, Ire tiaaeseaof, oeguteteny hodyappece,bofaredo reocbabonybody oaeneeoiag lay ItalIan dol is tithi, thajoeisdiolionafthesooodeoey body, the Iicnrea must disdote, Isdobmi of his orhno isessledno, slather ee ieotnabote rdadceafthehr~ss7 aoplaysl by do regabateey body, or

2, lIes any bmaesisl, haoiao.s, penfaeiseel an personal rnlatiaoohip “0th a meaoher or aoqtloyos of tienogototnoy body’,

(AdderS no MRS by mInlIltas)

NRS 62U11 Cees.is csolo.5 lofsrocrloo sod retied, proteobed roots dIsclosure lfeaypmsioiseofthmsIda roqoleos a regdaboy body to dioolooe isfeonaotioc, to the pablie is cay paraosdiso ores sob ninny oared, etch

peesietan dna oet apply Ia soy panteoal eeodinal isfemeaiao or recent era patient hal are ooafalenticd ornthosolnepoohscledframdiectseaoebyoaay othm1mosieiso of fadsel or state loso’,

(Added Is MIS by 151002.14 7)

NRS 022.110 Shone0 etC 100anonlha, rnlentoE Itt pablla becllb rnoasrnc: blot ovosl~cltoso n-ieh HectlbD’nl,tno ofDepcrtseeol a(HocIlh cod loaeco Soostres.

I, Mv ogdonoay body 010y thooe itefsototmooisit, possadno oladog to pahSa haalth aaraosn tith Cay othoree(dalooy body sod “Oh do Ileale Di’idan of do Deportaeanl of Health and llaotoo Sasice~ if dooenjjdla,tisllsp of do information is otharssisa eaoiataitod is aocardaeae ‘0th do bolts and oomdteeos oeqaioed bylass’.

2. An, ongablnoy body cony coodoal ojoint isvmtieatiee ssiththe health Dialdo, ifeithernfthoo 00 lnqaantiaol the regaletaey both’ cost do Health Diatino ‘pee thaI each of these, sill bonoflt Son ooodaal’mo a jebblisrosbeetot.

lAddod to MRS by lj11LOjdi)

9105 622,120 booppllneblhley of noesal, peon-aloe of Opno hteolloe Lot, eat ereseto bone Igclacypraoceliogc; cppllnehtltly sCebal prnsi,too to cone), dl,olpllocny potoesslhoec.

I, The poao’ioiaoo of MOO 14) O’O Is cat apply to peascenlirge relatial IC so ioo’osnieatioo aordtatad adaoamise nltether In peoceod snith diso4dmnany lotion seaissl a liratea, ordeas do honoree oeqaente dol doptoeetlioqnhecoedaolod poesesotl In dose s,vitioos

2. If do reoodaeey body denidoshe poooased ,oith thociptieety’ nolan agsioadolka,see, oi gooceedi000 that ~0’caodated aitmthal doniotion and are reloond no dot dioriplioa~’ oatiao ant eobjoot to dopanoiders of td00 241 Ct.

(Added Ia MRS byli?1k341fl

TITLE 54’ PROFESSIONS. OCCUPATIONS AND BUSINESSES

CHAPTER 622. GENERAL PROVISIONS GOVER24INO REGUI.ATGRY BODIES

GENERAL PROVISIONS

00050SI,rlte Oefldsiens,3113111.00 °IneeedIeIe telalbee’ dotted.31111110 oueonso dele.e&‘bs.Selt,tab °IJoesno°dcllood.

~3315~ eyIos_refc tstndsIosT body’ dstbseel,ate,., °ooasalasot7 Os’ delood,

3113 a an~ts~.cb

~t-e

TSsaISsest-st

~Ojon

~020 alLOt

REGULATORY PROCEEDiNGI1 RECORDS

ATTOP2)bEY’S FEES AND COSTS

tOES 622330 Cannatla ttlran,,nl .(,o.nantnt P.nn,dttne fit, .pprani.g; d.onnnad pablic r,gnrdn;.n.rptitai

I - Eacanpt ntbnoniae ptenidaa (an this nnnatinn, ccpdetny body ‘toy not ante, (tan a canaan a, atttt,etattnaralaraint aith o go,an aba baa ollegedly nanmniaal a niablion ‘lacy poseidon ‘Ida. tadetnlarhthnntgabotanbody ban ann antthaisly It ‘nIt,,., any rogataban adapted pnaoaant thereto or tony ardor at tha ,e,alatony body,mclean ore datan, body di atand appran boteania althe agneateat ian pabtirnicettog.

2. A .agalaln.y body (at aaaiann or am tal,aol anonan may otter into a ratios or oealanaan aaaeernentai(oamploiiththapaoniotonoafnnbntr(an lit:

(a) The .agdatony body pads retire to accordance aids the reqaimanats tat notice tar a atadag [ant paoaactIa cb~y~ar 24; alteRs nod nit, attic, ntatasanat

(I) The regcdatany bad,’ inteala no cocaine nine allecal ‘lotation by mttng tow a raaaant no ocattamantagaeeaait ncinlt the paaan “ha allegedly rtanacitted do nialadoty aId

(2) ta, the tanitad dam ad toot in the nohca~ ann’ conan may neqcon thai the nenatatony body roadan apablic.ainenadi.caaathetaafdocaneataro’tdmanataenrn.tbynnthnnitdnsgaaniltetraqaadfarnnalonnneattotathc cagalatne, body aids, an, dat. p.oaatibad in do ,tita and

lb)Atthn a~pinodna alUm done perattisbol (ad., rein., do oagntatany bob’ baa nat rerdr,d any ncqcona thaataibtie meeting nogoodeg the ransom a, nat000antainmoant

I. tin otntdatony body ado, ante a nananal an neithinoot nnoe000ton that ia atdiant to the pronidara alnidamotion. theagraeanoti at paNic ranagi,

4 Thn pnnc-’niaoa at dda oacdan do nat apply to a aa,ono,a or naltte.nenn agnnteanont betaeen aregatatany bad>and, ticanona dot pennido tar the donate a coon dicacdanaan’ tongnoan tha the fleatateant nlalnnbol. nheedcai oronbantrce abase on nlepordonny.

lAddad to NatE by 205013417)

NatE 621240 keqnlrnnn.nln P.r nnoaltoan tn,da.lnd by .ndln or n-Ida, notr,ankr.n,g.I. E~cepI na athencine pnonidnl to NR( 622 lie,, notice ‘I. meeting ala regtdntany body, no engined panacean

to CR1 ‘4t,021n,aanan (njant, inhodnat dna nnmdag toil baanndannnd byan ntdda no nidnn ndannnnfoaao at nta arbtnaaiana.

2. tIn nepdatary body- nnainatn, meeting by no andia a, ado taknnnfnnmra at a tanadan nonnifad in dannn&eplaatantta nnbaacniae Ida, agidatany bad” dana altona’ nay conan paoacitt at that toantian In pniiaipate inthnnnnatia~

‘mc pmnia(aoa at thin nacdnn do ant pnoh(bit annantatany bndy baa balding antanad noting nr paeotenting apoana (noon p.aliaipadan toaanaoing inaannadoneaithrhantthfll ollabS.

(Added no Nina by iiel&2≤d>l

Nina b223)6 Carnal, m,nllgen rnndnnnndnannld. nnnne ltnnhlbllont.I. Anagatatnrybnn~’ ‘tall nan botdnnntaatiata ntnlmat(an that ii nanoide doe State if:(n)lltennadtog in onbjnnt In thnp.anidnnaal(bigict4tol[O62;ntdlb)Dae(ng the tamniana a, any gordon aid., amdag, the atnalntany body annndnata nay banianan ,anndng tathia

titter2. The gaaniaiann al nnb,endon t damn prohibit a nannabat atamealataty body — atbancdtog nnndnnatinnal

nanninar, acteat tannaola.aianat dacdtptnant nn dnaitar nada-ily than in anndennaad nalaid, thin Itatr(Added to NRS by tiil’i(a2)

NinE 622360 DIngiptinnoy peanaedlnngnt Li,annne eaqatrnd nn nabnnln nngnrpnlnnn; nddlnta,an gnannndn Tntdlndpnnnovnanltaa.

tIn rcnntalany bad>’ iniliatan dinaiplianay paacarding, against a ticenant ponanent In thin tile, do tiaenaeenbdt. aidon 30 don, oile, the Inenate rendrec natilinotina nlthe toidatian nI the di.niyticnay geaceedtoga, ,nbaainIa do nngatata.y body a nnmptnta net nI Ida an hot thnaeaaanialn and anintea penndnainn .nthaniairng do negabnan,’body to lancnnddo I,nanannintabathe Canaan Rapanitaty Ia, Necndn Seconds nlCrinatoni harry thrntnbniina’iaatnthnrndcannnnnasantnnvnatigniinnlan itnrnpnnt

2. The millIng lnibaa nI do niaennaee In macply aid. the nnoninnacnta of ,cboortinn n natnaitntea an anijiiandgenned Ian nba regnntanery tasty a abe di.noiptianay action nnn.inal do tinonane, iantnnlinn, aidoneO boitadnnn,ntnnpnndiaannaavaningthaliannoanfdo(aanoei

3. Aneanboary body bean addidaant gm and larnaling dinniptinany nadan nantoan the hcannaait:

(nI The ra1nnn ban do Pedant Onaoaa of lacbygntiao inalimatea that do niatanaea hen — nntniatnj alannmtaatal act that inn gnatnnd taanatthng diniplanay nadon agatoodobeenor pnanact to don dOer and

(hi The .aganntng body Inns noon talon any flr dinaiintioaty nation ogainan do ttoataaa based on dnan nadnaind

I Tn do nasanat pnmibta, do pnncudtnn nt thin nendaa nat iadandal no onygatemon ador aacaony goeniaiannnconning dianiptinany pcmeedtoan. If thorn inn nannlian banana, Inch nttna pnnnidn,nn and do geantidnnn nl don.ecdae. do other pnaniainaa cannot to do mona (can dat adoc pnanidnaa procide mane nyeilnr reanainanientaaand’aadodimbdtonnl,banonn

(Added to NRa by 205i&liaa)

An0RNnV’n FEES MiD COSlE

OatS 622.40 R,nnn,nynnf annarnoyn torn md conga lnnnrred by rngnnnnnny bandy In ‘main r.0annnanypinreodigen.

A nagntanny body tony manse finn a ponen nananebte neanafl — nod anntn dot nor ictnnnl by doneanlanany bad> as non alit, inceanigadme, adatindonatina and dinniptienncy p.otan]inga naninon do golan if thereactatony body

In) Enten a Oman nrden in nnltieh in lads don the nnonnn ban notated nay pnoninian nI this den banish doregntatay body hoe do anthedny a color,, any reandadon adapted pnnnoaat thereto or nay order tithe regednnonybad>; or

(ha Tattoo into. not’on an ,eatonaa agrentanna to nchirh do rartdatony body lad, an do pornan attain nr —ret cannon dot do gonaan baa niatatad nay paac-idna at lid, ide noun, do rogalatany’ land>’ inn, do anathadny tnnnfanna,nayaanaadanodaptndpoaaaannthnnnnnnntty ntdno ‘(do anndennny body.

2. Anaaed’nthinoeedon,”caana”nannnao(n)Cnnannteaianannigadaer(b)Cnntn Inn ptntlannpba. loatimnito, loge di,taen lataphnnot rena and paatn(a and ddimny.(a) Teen formats reponnasan nay drpaddmne an innntngn,(daynanrnaonnnon ainannano and ado, aibantonan an any dapadtina nrtnnminoer(r) Pete mr nnaneaaey indapn,tenn an any deyadtia,a or bnninngc(a) Iran I., tannin ntd ddinny alnaacecs ned nnlgaaaan,at Fepeooee Inn noearmb. tomtiadieg, aithend liandtatian, ramenabte nod nannoanny nantannon Itr aannpntoneed

,an’ico l~, oral neananaalc(Added to NRS by 2(0213411)

Nina 622.310 Rmannne.y ,nrannnn ran,-’. r,en nod g.m mmmcd by m,gntnnany body I.A coats ‘ball annnrd tan .epabno.y body rn,naanabte aaannnty’. lean and rnnannabte cotta aynanifnei tothan are bonrndbydonegndatnny body no bong ar ddbadbaaey nation U

I. line nanina relates In do by nitiaa ar mmncny of nat ndnnininnadcn no ainit ,nmobt no poadny, domifanmaaaoat alert’ aabpaeona bond by doregntaary body ar the eofarrnaon olanypeaninian althia dIn, cnbiahdo nagatntnty body baa do mdoniny to tartan, any nagndndna adnpaad ptnnnnnnn thannte at non nadna nf doreadanaty bad>; ond

2. The nolan domonainen that do regndatany body in the penn-dt’mg fanny to do ‘cia.,(Added to NRS by tiItiid Ill

Investigation and Processing of Disciplinary “Complaints”

John A. Hunt, Esq., Board Legal Counsel

Since January 1990, I have acted as General Counsel &Prosecutor for theBoard. Since then the disciplinary process has changed to meet the needs of thecitizens of the State of Nevada. The following is an outline of how disciplinaryactions are currently investigated and processed.

The disciplinary process usually begins with a telephone communicationand/or a letter of complaint from the complainant. These complaints are firsthandled by the Board’s executive director. The Board’s executive director thenassigns those complaints to a disciplinary screening officers.

Upon review of the complaints by the respective disciplinary screeningofficers, herein referred to as the DSO, the DSO determines whether to request thecomplainant file a verified compliant. Sometimes a complaint filed by thecomplainant is verified from its inception.

NRS 631.360(1) states:

“1. The board may, upon its own motion, and, shall, uponverified complaint in writing of any person setting forthfacts which, if proven, would constitute grounds for refusal,suspension or revocation of a license or certificate underthis.chapter, investigate the actiqn~ of any person holdinga certificate.”

Unless a complaint has been verified, the DSO may only contact thecomplainant and the licensee. Upon verification of the Complaint the DSO maycontact third parties (i.e. witnesses, experts, subpoena records) to determinewhether there have been any violations of either NRS 631 or NAC 631. It should benoted pursuant to NRS 631.360(1), the Board may, on its own motion, authorize aninvestigation. Such investigations usually result from anonymous information whichthe Board, by motion, must authorize an investigation. Once the complaint is verifiedit is forwarded to the licensee for response. Pursuant to NAC 631.240(2), a licenseemust file a response within fifteen (15) days after he receives notice and a copy ofthe complaint. Upon review of the complaint, the answer, and conducting apreliminary investigation, the DSO has three (3) options.

1

VOl ].S427vJ. 08/2e/09 -

1. The DSD may remand the matter to the tie. In suchcases the complainant and licensee are usually informed that althoughthe DSO has remanded the mailer to the file, in the event there are anyfuture complaints, the remanded matters may be reviewed in any futuredisciplinary actions. It should be noted, the remand can be done withor without conditions. Pursuant to NRS 631.368, letters of remand arenot public record nor are they reportable to the National PractitionersData Bank.

2. The DSO may enter into a stipulation with thelicensee. Usually, stipulations are entered into wherein the licenseehas had prior letters of remand, therefore warranting additionalremedial action. Stipulations are submitted to the Board for approval.The stipulations are public record and the actions taken, pursuantto thestipulation, may or may not be reportable to the National PractitionersData Bank. The benefit of a stipulation versus proceeding to aninformal hearing, as described below, is with a stipulation there is notranscript regarding the testimony given by the licensee during thecourse of an informal hearing. In the event the DSO finds there hasbeen a violation of any provision of the Dental Practice Act, by enteringinto a stipulation, any further costs, which are usually assessed to thelicensee, are minimized.

3. The DSO may request an Informal Hearing Officerbe assigned to the matter. According to current Board policy, the DSOhandling the initial review is assigned as the Informal Hearing Officer.The assignment of an Informal Hearing Officer is authorized pursuant toNRS 631.363(1) which states:

“1. The board. may appoint one of itsmembers and any of its employees,investigators or other agents to conduct aninvestigation and informal hearing concerningany practice by a person constituting aviolation of the provisions of this chapter orthe regulations of the board.”

2

VG1 ].8427v1 08/26/09

After further investigation, the Informal Hearing Officer has two (2)options.

1. The DSO again may remand the matter to the file with orwithout conditions. The remand usually will inform the licenseeand the complainant that although no further action shall betaken by the Board, in the event any future complaints arelodged, the remanded action may be reviewed in determiningfuture disciplinary aOtion.

2. The DSO/lnformal Hearing Officer may request thelicensee appear for an informal hearing. Pursuant to NRS631.363, the licensee shall be given at least ten (10) days’ noticebefore the setting of an informal hearing. The informal hearingpursuant to NAC 631.255, must be transcribed in permanentform by a court reporter licensed to do business in Nevada. Alicensee may choose to appear with or without counsel. TheInformal Hearing Officer, Board Counsel, licensee, counsel forthe licensee, and the court reporter are usually the onlyindividuals present at the informal hearing. Whether or not thelicensee chooses to appear at the informal hearing, the Findingsand Recommendations are prepared by the DSO/InformalHearing Officer and submitted to the Board for consideration.Thereafter, the Board may set the matterforafull Board hearingto consider whether or not to implement the Findings andRecommendations submitted by the DSO/lnformal HearingOfficer. At the full Board hearing the complainant, licensee,witnesses arid experts may give testimony for both sides.

At the conclusion of the informal hearing the Informal Hearing Officer hasthree (3) options.

1. To remand the mailer to the file as previously describedabove.

2. Remand the matter to the file with a finding there were noviolations of either NRS 631 or NAC 631.

3. Pursuant to NRS 631.363(3), the Informal HearingOfficer may issue findings regarding violations in either

3

VG1 18427v1 08/2G/09

NRS 631 andfor MAC 631. Upon the finding of a violationof either NRS 631 or MAC .631, the Informal HearingOfficer then makes recommendations as to theappropriate discipline for the identified violatiohs. TheFindings and Recommendations are reduced to writing.

In the event the Informal Hearing Officer issues written Findings &Recommendations pursuant to MRS 631.363(5), the licensee who is investigatedmay consent to the Findings & Recommendations of the Informal Hearing Officer.

If the licensee chooses not to consent to the findings and recommendation theprosecutor for the Board may file a formal complaint with the Board based uponthose Findings and Recommendations requesting a full Board Hearing.

If the licensee consents to the Findings & Recommendations the Board, at itsoptiDn, may adopt the Findings & Recommendations as its final order withoutconducting a fuN Board hearing on the matter.

If the Board either refuses to adopt the consented Findings &Recommendations or, if the licensee chooses not to consent to the Findings &Recommendations, a formal complaint may be filed by the prosecutor requesting afull Board hearing. In the event there is a full Board hearing pursuant to NRS631.363(4), the Informal Hearing Officer shall not participate in the full Boardhearing. However, the Board may consider the Findings & Recommendations of theInformal Hearing Officer. A copy of the Findings & Recommendations must be sentto the licensee being investigated pursuant to NRS 631.363(3). At the conclusion ofthe full Board hearing the Board may impose discipline, if any, pursuant to NRS631.350. The disciplinary options available to the Board run the gamut from publicreprimand to revocation.

Once a final decision is rendered by the Board pursuant to NRS 233B.130 alicensee may petition the District Court for judicial review. The petition for judicialreview must be filed within thirty (30) days after service of final decision of the Board.A licensee may also request a rehearing within fifteen (15) days of the date afterservice of the final decision. Pursuant to NRS 233B.130(4), an order granting ordenying the petition for rehearing must be served at least five (5) days beforeexpiration of the time for the filing of a petition for judicial review.

Judicial review, pursuant to NRS 233B.135, of a final decision of the Board

4.

VG1 18427v1 08/26/09

must be conducted by a Court without a jury and confined to the record. The DistrictCourt shall not substitute its judgment for that of the agency as to the weight ofevidence on a question of fact. The District Court may remand or affirm a finaldecision of the Board or, set it aside in whole or in part if substantial rights of thelicensee have been prejudiced because of a final decision of the Board.

The burden of proof is upon the licensee to prove the Board’s final decisionwas based on one of the following grounds:

a. In violation of constitution or statutory provisions;

b. In excess of the statutory authority of the Board;

c. Made upon unlawful procedure;

d. Affected by other error of law;

e. Clearly erroneous in view of the reliable,probative, and substantial evidence on the whole record; or

f. Arbitrary, capricious, or characterized by abuse of discretion.

Finally, the Board or the licensee subsequent to the District Courts ruling mayappeal the decision to the Nevada Supreme Court.

The information contained above is a summary of the disciplinary process andadministrative procedures currently implemented by the Nevada State Board ofDental Examiners pursuant to NRS 631, NAC 631, NRS 2333, and NAC 233B. Thesummary given above should not be considered to be all inclusive. The readershould review the statutes and regulations cited above for a more in-depthunderstanding of the proc?dures and regulations that control the investigative anddisciplinary process regarding dentists in the State of Nevada. Licensees shouldcontact independent counsel should they have specific questions regarding the legalsignificance of the.procedures cited above.

5 -

VG1 18427v1 08/26/09

INVESTIGATrONS

TELEPHONE AUTHORIZED NAC 63 1.240 (WTIONS FINDThIGS &COMPLAINTS 4NRS 63 1.360(1) CONCLUSIONS

WRITtEN N COMPLAINT REMAND BOARD MAY4% 7NOTrFICATION—3 DSO .-~ CONSENTS ‘>OR MAY NOT

I BY MOTION AT ASSIGNED— STD’ULATION ADOPTI MEETING OF ANSWER \ 4,I THE BOARD INFORMAL\INFORMAL LICENSEE DOE~ FORMAL BOARD DISTRICT NEVADA

WEARING NOT CONSENT. HEARINGS COURT ~ SUPREME

I OFFICER COURT“I, . NRS63I,350

EXECUTIVEDIRECTOR

r.c.’o

A

PROPOSED MOTION BY DR. PICK.

Motion: Pumuant to NRS 631363 (1), I hereby move that the Board’s policies reganiing theassigmncnt ofDisciplinary Sczeening/Jxufor~I Hearing Officers be revised as follows:

1. The present Disciplinary Screening/Infr~ial Hearing Q5cers are hereby reaffimiedto execute those duties. Currently the Disciplinary Screening Officers/Tnformal Hearing Officersauthorized by the Board are )k Robert Lysgaazd, Dr. Stephen C. Vaughn, Dr. Susan S. Jancar, Dr.Dennis!. Aith, and Or. William I. Busch.

2. Pursuant to this motion, theDisciplinary Screen ng fOrmal Hearing Officers alreadyapproved shall continue with the matters presently assigned.

3. The number ofDisciplinary Screening Offlcersflsfonnal Rearing Officers shall notbe limited to any given nuinbet The Board shall appoint dentists to act as DisciplinaryScreeningiIji1o~~j~j Heasing Officers upon those dentists being approved by the BoaM at aproperlynoticed meeting. A Disciplinary Screening Officer and/or Infbrmal Hearing Officer may beappointed to matters within thefr same geographical area.

4. Once a dentist has been appointed by the Board as a Disciplinary Screeaing/hiformalRearing Officer, the Board’s Executive Director shall have the authority and may assign Disc~p1inaxyScrceningITn~,rmaI Hearing Officers to new matters being processed by the BoaM’s ExecutiveDirector. In the event a Disciplinary Screening Officer and/or Itnnal Hearing Officer, fbr anyreason, can no longer process a given matter, the Board’s Executive Director shall have the authorityto appoint a substitute Disciplinary Screening Officer and/or Informal Hearing Officer.

5. Once a dentist has been appitved by the Boasd and assigned to a matter by theBoard’s Executive Director, the Disciplinary Screening/Informal Hearing Officers will conductreviews and/or investigations pursuant to the fillowing procedures:

a. Upon the Executive Director’s receiving an oral complaint, either in personor by telephone conversation, ifthe matter cannot be resolved by the Executive Director, theExecutive Director may assign the matter, to a Disciplinary Screening Officer who in turnmay contact only the complainant and the licensee in an attempt to resolve the complaint.In the event the Disciplinary Screening Officer assigned believes liuther review is necessary,the Disciplinary Screening Officer will request the Executive Director attempt to have theoral complaint verified in order to commence an investigation pursuant to NRS 631.360 andNRS 631.363.

b~ Upon the Executive Director receiving a non-verified written complaint andthe non-verified complaint cannot be resolved by the Executive Director, the ExecutiveDirector may assign the non-verified written complaint to a Disciplinary Screening Officer.In the event the Disciplinary Screening Officer assigned determines no finthe’r action isnecessary, the Disciplinary Screening Officer may remand the matter to the Board’s files.

c~vflxiawnnDr~rAvjrcxMor

I Iflfl.~ .Jr). 4.~sU .t• ZSflI•L F~ fl Cc ri flU• V. dFd

In the event the Disciplinaxy Sore~ning Ofllcer assigned believes fljtther review is necessa~y,the Disciplinary Screening Officer will request the Executive Director attempt th have thenon-verified wdtten complaint verified in order to commence an investigation pursuant toNRS 631360 andNRS 631.363.

o If the Executive Director receives a verified complaint, pursuant to NRS631.360. the Executive Director shall forward tire verified complaint to the licensee ibr ananswet Upon receiving the anawer of the lice~see, the Thteeiitive Director shall assi~ aDisciplh,azy Screening Officer and ~rward copies ofboth the complaint, answer, aud anys~ppIementa1 information to the assigned Disciplinary Screening Officer, lithe assignedDisciplinary Serecuing OIftcer, after bvestigaiing the complaint and the answer andrevlewtig annie Mth Board counsel, dct~iincs no further action is necessary, the complaint,answer, and any supplemental Information, the matter may be remanded to the Boatti’s ifies,If the Disciplinanj Screening Officer detemiines a further investigation is necessary, theDisciplinary Screening Officer assi~ed shall automatically become the ~formal HearingOfficer assigaed to th~ matter. Thereafter, the Disciplinary Screening/Informal HearingOfficer ía authorized to conduct am infbrmal hearing as set Itiith in NR$ 631.363.

UI~AXThI~WP5HbnNThLi!aMO~

Nevada State Board ofDental ExaminersTelephone Conference

March30, 1998

President Twesme called the meeting to order at 5:30 pm.

1. Roll Call and Establish a Ouorum

President Twesme asked VaLenne Harmon, Executive Director, to call the rolL

Dennis Arch, DDS PRESENTJudy Bowmer~, RDH PRESENTLarry L Champagne, DMD PRESENTTony Guillen, DDS PRESENTJoyce Herceg, RDH PRESENTMichael G. Hollingshead, DDS PRESENTSamuel B. Piclç 1)1)5 PRESENTMrs. Dorothy Raggio EXCUSEDBradley Roberts, DDS PRESENTA. Ted Twesme, DDS PRESENT

. Also present was John A. Hunt, 1%, Board Counsel, and VaLonne Harmon. Guests were BettyPate, RDH Mary BOWU, RDH Leanne Truesdale, DDS; Ms. Armida Jones; Ms. Dominique Jones; Ms.Donna Carpenter, and Cassius Battle. With a quorum present the meeting was opened for business at5:33 pm.

2. Old Business

a. Dr. Twesme led a discussion of the proposals submitted by lobbyists who are interestedrepresenting the Board during the 1999 legislalive session. On motion by Dr. Champagne, seconded byDr. Pick, the Board voted .in~niniously to invite all eight (8) lobbyists to a regular board meeting. Ms.Harmon was authorized and directed to contact each of the firms to schedule interviews at the Friday,April24, 1998, meetingin Las Vegas.

1>. The next item of business was a discussion of the proposal regarding the hiring of alegislative liaison to work with the Board president and the lobbyist Dr. Twesme reiterated Dr. Jancar’soffer to serve in this position.

After discussion, on motion by Ms. Bowmer, seconded by Dr. Champagne, the Board votedunanimously to assign the duties of the legislative liaison to current Board memim By this vote, theBoani also authorized reimbursement of Dr. Janca?s expenses for the Mid-year AADB meeting inChicago. Further, because the connct was not adopted, any future expenditures must be pta-approvedby the Board

1

c. The Board discussed the dates for the 1999 dental and dental hygiene Jicensu.zreexamination. On motion by Dr. Roberts, seconded by Dr. Arch, action on this matter was tabled forconsideration at the April 24, 1998, meeting.

3. New Businsa

a. Mr. Hunt reviewed suggested revisions to the protocol for processing complaints andthe Disciplinary Screening Panel. Mr. Hunt stated that the complaint process was progressing verysmoothly and tEnt the revisions were ircessary to mate minor a4justinents to previouslyadopted protocol.Dr. Pick read the following motion into the record, it was seconded by Dr. Hollingshead, and the Boardvoted unanimously to adopt the motion as read.

Motion: Pursuant to NRS 63 1.363 (1), thereby move that the Board’s policies regarding theassignment ofDisciplinary Screening4lnformal Hearing Officers be revised as follows:

1. The present Disciplinary Screeningll.nfbnnal Hearing Officers are hereby reaffirmed toexecute those duties. Current the Disciplinary Screening/Infonnal Hearing Officers authorized by theBoard axe Dt Robert Lysgaar4 Dr. Stephen C. Vaughn, Dr. Susan S. Jancar, Dr. Dennis .1 Arch, and Dr.WilliamS. Busch

2. Pursuant to this motion, the Disciplinary Screening Officers/Informal Hearing Officersalready approved shall continue with the matters presently assigned.

3. The number of Disciplinary Screening Officers/Informal Hearing Officers shall not belimited to any given number. The Board shall appoint dentists to act as Disciplinary ScreeningOfficers/Informal Hearing Officers upon those dentists being approved by the Board at a properly noticedmeeting A Disciplinary Screening Officer/Informal Hearing Officer may be appointed to matters withintheir same geographical area.

4. Once a dentist has been appointed by the Board as a Disciplinary Screening Officer!Informal Hearing Officer, the Board’s Executive Director shall have the authority and may assignDisciplinary Screening Officers/Informal Hearing Officers to new matters being processed by the Board’sExecutive Director. In the event a Disciplinary Screening Officer and/or Informal Hearing Officer, forany reason, can no Longer process a given matter, the Board’s Executive Director shall have the authorityto appoint a substitute Disciplinary Screening Officer and/or Informal Hearing Officer.

5. Once a dentist has been approved by the Board and assigned to a matter by the Board’sExecutive Director, the Disciplinary Screening Officers/Informal Hearing Officers will conduct reviewsand/or investigations pursuant to the following procedures;

a. Upon the Executive Director’s receiving an oml complaint, either in person orby telephone conversation, if the matter cannot be resolved by the Executive Director, theExecutive Director may assign the matter to a Disciplinary Screening Officer who, in turn, may

2

• contact only the complainant and the licensee in an attempt to resolve the complaint In theevent the Disciplinary Screening Officer assigned believes further review is necessary, theDisciplinary Screening Officer will request the Executive Director attempt to have the oralcomplaint verified in order to commence an investigation pursuant to NRS 631.360 and NRS631.363.

b. Upon the Executive Director receiving a non-verified written complaint and thenon-verified complaint cannot be resolved by the Executive Director, the Executive Directormay assign the non-verified written complaint to a Disciplinary Screening Officer. In the eventthe Disciplinary Screening Officer assigned determines no further action is necessary, theDisciplinary Screening Officer may remand the matter to the Boards flies. In the event theDisciplinary Screening Officer assigned believes further review is necessary, the DisciplinaryScreening Officer will request the Executive Director attempt to have the non-verified writtencomplaint verified in order to commence an investigation pursuant to NRS 631.360 and NRS631.363.

c. If the Executive Director receives a verified complaint pursuant to NRS 631.360, the Executive Director shall forward the verified complaint to the licensee for an answer.Upon receiving the answer of the licensee, the Executive Director shall assign a DisciplinaryScreening Officer and forward copies ofboth the complaint answer, and any supplementalinformation to the assigned Disciplinary Screening Officer, If the assigned DisciplinaryScreening Officer, after investigating the complaint and the answer and reviewing same with. Board counsel, determines no further action is necessary, the complaint, answer, and anysupplemental infomiation may be remanded to the Board’s files. If the Disciplinary ScreeningOfficer determines a further investigation is necessary, the Disciplinary Screening Officerassigned shall automatically become the Informal Hearing Officer assigned to the matter.Thereafter, the Disciplinary Screening Officer/Informal Hearing Officer is authorized toconductaninfornulhearingas set forthi&NRS 631.363.

3. New Business (continued)

b. The next item ofbusiness to come before the Board was the consideration of Dr. BradleyRoberts for the position ofDisciplinary Screening Officer/Infonnal Hearing Officer. On motion by Dr.Arch, seconded by 1k Pick, the Board voted imanmously to name Dr. Roberts as a Disciplinary ScreeningOfficer/Informal Hearing Officer. Dr. Roberts abstained from voting.

c. There then came on before the Board a request by the Executive Director to authorizeinvestigations into the actions of two license dentists. On motion by Dr. Pick, seconded by Dr.Champagne, the Board voted unanimously to authorize an investigation of Dr. X based on action byanother jurisdiction and an investigation of Dr. Y for failure to report an incident pursuant to NRS631.155.

d. The next item ofbusiness to come before the Board was a request from the Nevada DenialAssociation that the Board participate in NDA’s state-Wide newsletter. After discussion, the Board

. 3

authorized and directed Mr. Hunt to draft an article regarding the ststutes and regulations along withcommon violations and provide this infonnation to tire NDA newsletter editorial staff.

e. There then came on before the Board requests from two dentists for certification inspecialty areas of dentistry. After reviewing the applications and credentials, the Board took the followingaction: On motion by Dr. Guillen, seconded by Mrs. Hcrccg, the Board voted unanimously to grantspecialty certification for the practice of Endodontics to Margaret M. Ashe, DDS. On motion by Dr.Roberts, seconded by Dr. Arch, the Board voted unanimously to grant specialty certification for practicein the field of Pediatric Dentistry to Dawn L McClellan, DDS.

Dr. Twesine announced that Ms. Arniida Jones, a member of the public, was present to address theBoard regarding dental anesthesia On motion by Dr. Pick seconded by Mrs. Bowmer, the Board votedunanimously to go offthe agenda and allow Ms. Fones to spat Ms. Jones related that on August 18,1992, her son, Cassius Baffle, was sedated for dental treatment by an anesthesiologist working with apediatric dentist As a result ofequipment maltirnetion, Cassius had significant brain damage during thefreatinent Ms. Jones encouraged the Board to adopt stringent regulations regarding dental anesthesia.Ms. Jones answered questions from Board counsel, and Dr. Twesme thanked her fix her interest in thismatter. The Board assured Ms. Jones that the regulations were undergoing review and revision with thegoal ofprotecting patients.

£ The Board considered the next agenda item, requests for conscious sedation permits. Alter• review and discussion of the applications, on motion by Dr. Guillen, seconded by Dr. Arch, the Board

voted irnsnimously to approve the applications and thereby grant temporary permits to Dawn L.McClellan, 1)1)5, and William F. Waggoner, DDS. The temporary permits are granted based on successfiulcompletion ofsite visits. Dr. Bmoksby withdrew his application for a conscious sedation pennit.

g. There then came on before the Board a consideration of the findings and stipulatedagreement, lore: Sidney it Adams, DDS. Mr. Hunt reviewed the stipulated agreement and informed theBoard of their option with regard to adopting or rejecting the agreement On motion by Dr. Arch,seconded by Dr. Roberts, the Board voted unanimously to adopt the stipulated agreement with Dr. Adams.

h. The next item of business to come before the Board was consideration of a stipulatedagreement in it: Keny D. Hanson, DDS. Mr. Hunt reviewed the terms ofthe agreement along with thecircumstances regarding Dr. Hanson’s request to re-activate his Nevada dental license with certainlimitations. On motion by Dr. Hollingshead, seconded by Dr. Guillen, the Board voted unanimously toadopt the stipulated agreement with 1k Hanson.

4. Announcements

Mrs. Harmon reported on Mrs. Raggio’s medical condition, and the Board discussed sending cardson an individual basis.

.4

• 5. Adjournment

There being no flurther business to come before the Board at this time, on motion by 1k Arch,seconded by Dr. Guillen, the Board voted unanimously to adjourn the meeting at 6:55 pm.

Respectfblly submitted,

§&&nss JeTa*mon

VaLonne S. Human, Executive Director

.

• 5

Index of dootutents

Exisilait It DescriptionDiscussion regarding Isistosy assd use ofcoerective action stipulations since 2000.

Exhibit IAlso there is discussion about May 201 I letter from the Director of the Data flanks, Ms.Gruhbs stating the Board was in compliaace with the data banks’ reporting requirements.See attached as sub-exhibit 1-C. The May 2011 letter from Ms. Orubb was sent AFTER aletter was sent nfl behalf of use Board dated Msarcls 3,2011 (responding to a February 2011letter from Ms. Orssbbs), advising and diacussing, in part, corrective action stipulations whichwere not nsporecd to Use data banks. 34. Again, Ms. Orubbs’ May 2011 detennination theBoard was in compliance with the data banks’ reporting reqniremenss came AFTER she wasadvised of the Board’s reasoning end basis for its use of corrective action stipulations andwhy they were not reported to the data banks, 14. AFtER reviewing this inlonaation, Ms.Grubbs’ May 2011 letter advises the Board it was in compliance with data banks’ reportingrequirements. This detennination by Ms. Grubba tlsat the Board is ins compliance with itsreporting to tlse data banks is eontinaed by else data banks website which notes Nevada,Dentist, as being ‘compliant” for its status as of 4/1/2011, 7/1/2031, 10/1/2011, and12/1/2011 (Else ‘atest date referenced).

Sub-exhibits within this Exhibit 1:Esbibia A: 8-29-I I description of duties for Board employees

Exhibit B: Corrective action stipulation Isiatosy from 2000.

Exhibit C: copy ofehe following letters and their respective attachments:* Ms. Grubbs’ February 2011 letter to the Board

2-3-Il response letter on behalfofthe Board to Ms. Grnbbs’ letter~ Ms. Grsihhs’ May 2011 letter to the Board adviaisig the Beard is in

reporting coinpilnisce

Exhibit 2 Data baiska website page printout noting “Nevada” “Dentist” reporting being “compliant” forshe periods there has been review from 4/1/li eo 12/t/l I

Exlsilsit 3 Table and discussio&commene regarding latest version of certain sections of the Code ofFederal Regulations ~CFR) re: else Nalionsl Pmceitioner Daea Bank (“NPDB”)

Exhibit 4 Table and diacLsasiosilcomrncnt regarding latest version of ccrta’es CFR sections [a:Healthcare isategrity and Protection Data Bank (“IIIPDB”)

Exhibit S Discussion of material regarding “HWDB Ostidebook” noting example of non’reportableactions and discussion ofmaterial regarding power point presentation by Ms. Grubb

Exhibit 6 Discussion of”Dear Data flank” from May 2012 Newsletter

Exhibit 7 Exansples ofother Boards using corrective action agreements/orders and NOT REPORTINGthem to the data banks

Exhibit

Exhibit

1

1

At the request of Wil]iam Busch. DDS Executive Director for the Boardaposition was createdand approved by the Board in October of 2002 at a properly nouced meeting to hire Ms. Shellerand Ma Shafferhire date is October 21,2002. Ms. Shalferpositionla tohandle theadminisrration of complaints and disciplinary process. This is consiatentwith duties describedin the August29, 211 document from Kathleen Kelly, Executive Director.SeelixhibitA

Attached as EXIIibitB are exnmp)es of stipulation agreements frdm 2000 to current and asummary attached The 2000 to current time frame is consistent with the NPDB Guidelinesdared September 2001.

As you review the stipulation agreements you will see different Disciplinary ScreeningOfficers. Board Presidents and Board Members. Although, the DSO’s, Board Peesidents andBoard Members have changed over the years the reporting of corrective versus advera, actionshas not changed. However, the amount of infonnatinn contained in the stipulation agreementshas Increased to better protect the citizens of the State of Nevada.

On February 2,2011, the Board received correspondence from the Division of Pnactitioners- Data Banks ~DPDB” regarding an audit fur compliance of certain adverse actions taken by the

Board that were not reported to the NPDB. On March 3, 2011,1 responded to the DPDB” with aresponse as well as exhibits including the NPDB Guidelines referencing Section E-24 and E-25.Eleven actions did not meet the NPDB Adverse Action Reporting Requirements for LicensingBoards. The additional five in question were updated and reported. one action was reported andI included the DCN reference number. See Exhibit C

On May 25,2011, the Board receivedfrom the Health Resource and Service Administration(HRSA). Bureau of Health Professions, Division of the Practitioners Data Bank, a letter advisingthe Board of “compliance” status as it relates to the certain adverse actions in question duringthe period of 2006-2009. Eleven corrective actions were not and have not beenreported as theyare not required pursuant to the NPDB Guidelines. Five adverse actioas were updated and havcbeen reported. One was oii~nally reported including the NPDB ldend4’ingnuenber.

Further, in reviewing the NPDB Guidelines the terms “corrective action plans” and “adverseactions” are terms used throughout the NPDB Guidelines. To insure consistency with the NPDBand based on the correspondence dated May 25.2011 from the Director of the Division ofPractitioners Data Banks [began using these terms in the stipulation agreements to betteridend~’ those which ale deemed as adverse and are reportable to the NPDB and those correctiveaction atipulationa/settleanents that are non-reportable to the NPDB based on their Guidelines.See Exhibit C

As you review the stipulation agreements dating back from 2000 to current and theInformation from the NEDE you will see my position regarding “corrective’ (non-reportable)and “adverse” (reportable) has not changed and is confirmed to be “compliant” as slated in thecorrespondence from Ms. Grubbs. Director of the Division ol Practitioners Data Banks datedMay25, 2011.

Nevada State Board of Dental Examiners

WiIUom C. Pappas D.D.S. Donna J. Helinlokal, D~D.S.PMsIdenl Sacratsiy-Jmaswer

SOlOS. flalaibow Blvd., Sldg.A, Ste,1 • Las Vegas, NV 89118 -(702) 486-7044 • (800) OOSXAM Fax (702) 486-7040

DUTIES: As of 8129t201 I

E)(T-IIBjj Kathleen 1. Kelly: ExcostiveDiotcuor Sam — Spun (Additioeel horns as achcduIc~Agency CbiefApplication Review

A Ensure ChnpttrComplinnce (NES!NAC)/Dinciplinsuy ounttcrsCeetiflj Board Documents? Issue SubpoenasBudget’ Financiul nuasagessentMedia Cosmce/nosrd Legal Counsel CoordinationLegislative Manugesnent / Nevada LegislatureIoaunsrce oIsuspetssioiss/Revocednns)RelsstalamentsLiaison with Licensing Sefiwero VendorCE Stipolsilon Approvals and Stipulation ComplIance Qadonilor wish mind)COOS Bound LiaisonCeceify Minules PreparationPublic Document Requests/State LiaisonExam coordination

DebruA. Shaffar Depu~, Excoslive Director t:OOasn —Spin (Addieionat bourn asucheduird)

Assist Overall Agency ManagemeneGack-up ED)Process Complaints I Meet w/ Complalannis (By tppt: Wedneodaye 1-Span)Coordinate Complaint Netica in LicenseesPnoceai Diuciptinaoy CaaeoMeet with Co,uplnintntsCoordinnie Disciplinary ltveatigauorsReport Disciplinary Case, I LCDManage Stipulation Compliance Gadoultor with 3liniot)Proensu Diociptinaay PaymentsProcess False Adreutiulog ClaimsMenage Malpractice FilingsMonitor Discipliensy Filings ofNoticc

Candtce Slraelon: Licensing Specialist 5:SOan—S:IQpaa

Manage/Process Licensing: general; upeciul~c restaicted; limited; hygiene; gen rculriceodProccsa Pocket Cards / CcitlficateaManage/Initiate License Renewal Proceos: Assiolcd by Rlgo/SandnufAngteProcess Rsinatatemones for InaceivcfSasspcnded5RevokedProceun Local/N20 Appliceeiona’ApprovolProcess Check Traeuactlosn DeiatttSuzumary

Rick tdniot, DDE: DSO Coordlneeor(Wcd l-4)(Part-eirnr)

Coordinatefrraln DEC I Hearing Ofiiccn

Complianca Monitor for Board Actiaeo) Stipulation Agreements?mcest Complaint NoticesReview Compleinls / Meet with ComplaInants for Dental Review

Sandra Spilsboty Adminialeauive Aaalstant It Ban — 5pm

Process Appllcedous/Coordinate Clinical Licensuro Examinations; Dental and HygieneProtean Public Health Denial Hygiene EndoesemenlaProtean Continuing Education Applicaelons!Revicw Reqnirerceals!AudltSr3aedtsllngProcess Travel: StalTand MembeosOffice Admlnisbatian I Order EquipneatlFnrnilurelRepairsSurispessdaxaea Exeseeiaetioo Coordination I Fingerprinling ~sclc up for Rigo)Updala all Applicallees I Poems / PacketsRulemalciagft1eellngs PoatingaNewsletterAnastbcuia Adnsbuiatauon (Coesclose SedatIon, Deep Scdatloe~ General Aneatheala): Schedule

Exataaa!pennle procensisg!re-ovate

Bigoberto Morales: Adeainlstmllvc Ausitlant U lBOam—4:lQpna

Coordinate Jurisprudence ExaminationMainlain and Process FiegeeprioiingvcsifecstioesCredit Card Processing! TraaaaetlanlPayencnla Dale EnlryWebette ManagementGeneral FilingProcess Stipulation Agreement! Board Aelion RequestsVeriticolloet ofLicensnretteqreabProcess Address Changes!lipdaiesl Process Name ClsaeagesAnswer Phones/Protean Mail (bacic up for Magic for plaoam)Media ClippisagsAssist Moaailortng Stipulations with Thhiot

Angelica Bojar: StelfAssisteat’Receplionist laes—Spns

Front Office Reception: Asswer estla/Direct calls / Greet VlailoreProcess lecomisag Mail: laelndtag faxesGeneral FilingBoard Meaoings: Ccordtnsle Board Book PrcpaaationsMainlain Minatta Book (Draft Mlnaatas) and mosrd AgendasDisseminate Email from NSBDE Master Aecoune for ReplyAssist Deputy El) with processing complaint foamsData Enisy for Licessing System—Assist CendieaPrepare/Mail Friday Psakeis to all Boerd MembersGeneral Administatlvc Duties

Andrew Kachtsrsk: Board Investigator (Part Thsae) (Rcnao)

Background InvcsilgallonaInvestigative RescsrcwSurve’llancoInacoviews Wimesses/Collerb EvidcnceAesisea DSOIHO with Complahel Investigations

- Approved 06/2010-OSO Byron Blasco, DM0 President Wifilam Pappas, DOS attorney Hunt(not reportable to NPDB)

Leonid Banthik, DMDSTIPULATION HISTORY (NSBDE) 2000-20il - Date of NPDB Guidelines September 2001

Stipulation-practice monitored, daily logs, additional continuing education, reimburse BoardJoseph Eberle, DOS coat of invest,relrnbuxae patients. stipulationuses term CORRECTIVE’.Approved on 1012011-USC Byron Biasco, OMD. President William Pappas DOS attorney HuntStipulation- reimburse Board cost of invest, monitored for 2 year, initiate informed consent (not reportable to NPDB)

foamsApproved 06/2000’ 1150-Stephen Vaughn, lIDS - President Dr Twesme— attorney Hunt (Notreportable to NPDB)

Lisa Hogan. DOS

Stipulation-practice monitored, additional continuing education, relanburse Board cost of investApproved on 06/2001-OS C Brad Roberts. DOS-President Or Champagne-attorney-Hunt- (notreportable to NPDS)

Michael Khanna, DOS

Stipulation- vcrl~ licenses and receive written notification from the Board for a period of 5years, reimburse the Board cost of invest, stipulation is not to be considered diacipline orreported as a disciplinary matterApproved on 07)2005-USC Stephen Sill, DM0-President Tony Guillen, DOS-attorney-Hunt(not reportable to NPDB)

John Hastings, DOS

Stipulation-practiced monitored. re’takeJP Exam, reimburse Board cost of Invest, Stipulationstates NOT REPORTABLE TO NPOEApproved on 05/2006 OSOJamcs Kinnrd, DOS-President Tony Guillen, ODS-attonaey Hunt(not reportable to NPOB)

Suznn Eu, DOS

Stipulation- practiced monitored, daily logs, additional continuing education. reindiurse Boardcoat of invest, reimburse patientApproved 10/2009-USC Dennis Arch, DOS-President William Pappas, 0115 attorney Hunt (notreportable to NPDB)

TcrrieKianee, DOS

Stipulation- practice monitored, daily loga. additional continuing education, reimburse Boardcost of invest, reimburse patient

( ~ DEPnThnNT or ~saIax, a auco~ satawess Hangs Rseauaaa and Seralese Mirlrlstiauen

Bsscat ofNealth Pro(moioas floslodhte, MD 20061

FEB

ExHIBIT Ksth~nKellyExecutive Director FEE 04Nevada Stale Board ofDsnlal Examiners lAP

C . 6010 South Rainbow Boulevard ‘8.&D ~SuileA-1Lao W800, Nevada 89118 -

RB Dentists

Dear Me. Kolly

lies Health Resources and Service, Admintthatioa, Division ofPnctitionerDaiaflantcs (OPDB) Isconunileed to partnering whit Sftie licosuisag sod eestlflcatlon boards to easeourego the comprehensivereview ofibe pro~sslonal credenela], ofhealth cast profesalonals, and to address pstientsafety, fraudand abuse nibs health care delivery ayete,n. To this end the DPDB hat unaderiakesta comprehensiverbvlewoftlsfldverao action, that State licensing mid certification bcerds submit to lee NatiosalPracdtloner Data Bank and the Realthcareintagrityand Proteeolon Data Bank (Dataieanks).

TheDPBD eevltwtac&a~p~soc4 a nnultisacp prqccan~whitJtineJudc4revie~i4ngsdvo~scactiosp1~the DPDB lsylheae eneisias. epd cqmpathog0seseda~.ag~a.ot.the.eosi.Qaatepqdedta.tbcfr~taflanka.

Havingeompleleel oureoinpa;iaea ofthedalaavailabiechrcrghyossróeganjgà~lon wills deerepoctsthat have bean submitted to den Data Banks for the years 2006.2019, our objective taCo collaboratewith licensing aed certification boards to ensure thatths lafoernatlon in lhe Dataflanks ii conipieeeand accurate. Thank you for the assIstance you have provided us to date. We welcome yourconetnued conparation.

Front our review, It tppeara that there are acliona/lndtvlduals that have not bean repsetedto the DataBanks serequteed. We have attached apreedaheet that conlainsties details ofour analysis.

In ordcrto finalize ourenalysls,wercqucstthatyou immediately reviewthe outstanding actionslisted on the atlaclaed apetadahect Within 30 calendar dtysths thilowingnext slops areecquierd toensure titan your orgeanicntion meets Data Sank, reporting etqolrtmenls.

a) Report the actions a, ycqulrcd need provide notice to ~PDB thatyota have done to;b) Srpply.e written eicplaantion slalingrelna eaeaen thee the noliens dp not nnqettlneeeporting

requirements: or . . a . .

c) Provide a CcrrcctiveActioee Plan (CAP) detailing howyonr Hoard will mcettala Sonic,nporting,reqtsjaqseqp. Thq.cA~qnu.stinciudep~oyipigqs.fqctlte.$~toli9cnniegros.cefiastionbtirdtqbeginaubmfltingqiIaeItgdasan~hipfJ4ays ql,sskml,aiireoftboCA~..ateathq~tpo~tjiheo allaslaslrrk4eaytlllb.eseppated and thp.etcpsflaaty,ill,botgkento ensure that flilure actions are reported as required.

Page 2— Kathleen kelly

The reault, of this DPDB review, along with iqidates on prior compliance efforts will be posted onthe Data Brides web,leo at hUndtwwwrodI~l,bdbl sa~,/ncnttoda~edmComollance4a, ottAprIl l.2Ott. ltisotargoeleoltelpyouahlaya”rooipllaetf’mtai. Yoawfimelygeoponseto thisrequest will help eosuretisatyour organlnllon’a raporting eampilante ii noted accurately and dietthe Data Dante data ace completa railers to reply or submit abe requested infom,ation within 30days ofehe date of this letter will result In the Sacensy oIHealtb and Human Services naming yourorganization at “non-compi iaar will, Data Banks reporting requireonasita on lbeNPDflpubtlowtbsiee. -

lfyou require asalulanee on Date Desks reporting requirements, pleaaavlait ourwebolte at:wvw.nn~-hIoda.hroa.~y. The wabsile contains the statutes and regulations thatprrtain toropoeling requirements, as well as faet sheets and asupoeaaeo to Fnqa,entlyAskcd Qtdesflo,os that maygtsldayorr efforts. You may also contest the Ciutotoer Service Center at (800) 767-6732 orhelo(Dnndb-loiodb.lonnov to ecquestasuialanre orb obtain a daeaflle (freeofehargc) containing allactions your organization tar ttparbed to the Data Banks.

Please send all requested information directly toMsogasita Morales, Conspllanoa Coonliraater, [email protected]. lfyou have any questions, please contaetMa. Morales at (301) 443-2300. Ifyou choose to com,oaussinare with us via U.S. Mail, our nailing address is, Division ofPmedtionerData Banks, 5600 ltlehara Lase,.ltoon, 8403, Rockellle, MD 20857. - -

Thank you for repoating your disciplinary esdono to tIm Data Banks as required. We appreciate youreontioued affoats ro meotourjolnt mlouionofproeecringiiaa public by etisuringthatthe informationIn the Data flanks Is accurate and compigle.

Sincerely.

&44L gfh~$~Cyn~d~ Orubba, l~N., J.D.DirekS~rDivIsion of Practitioner Data Banks

FEB04 ~

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Mj7___ tn~!c!~. — u40 NV_ -sa_ iic. n,,,t___ ,~ — ooas SN -Dedasa, n~5j~__ — — aata at! -aaat.u DatSun oondneao

Co Poe sat -Ca-eat ta-tic‘eiL_ ~c c ~~__ ~ r~__N-,~_ Row, — — 0470 SN -Dest,t attnAdat.n at 44a0 SN -Oettst a,tat iwsg/200aMrhaoy,ad S~t,ar 0. 0555 SN -o,ad,c ta-tao os/a,pvaaOa,,a,t honour — 4300 NV - O.adhe ta-too 25.~I~7~ta- amedd — tat ~raetat rant., beIfl/2rOaafro, aol 9755 err -Oaeeac sandal ai],t),egateas W,t rat -readat ta-en r~J2eer

FEB 04 2011

RAU~1IGR & HUNT, P.C.A1tomc~atZaw

500 South Etancho Drive, Suite 17las Vegas, Nevada 89106

702.486383570 2.486.3836 faesimilc

Marchl,20l1

Cynthia Ornbbs, RN., S.D., Director0/0 Margarita Morales, Compliance CoordinatorDivision of Practitioner Data Banks5600 Fiahacs Lane, Room 8—103Rookviile, MD 20857

Re: Correspondence dated Febrimry 2,2011

Coordinator Morales:

Ourfirno represents the legal interests of the Nevada State Board ofDental Examiners.Please be advised that I aim inreceipt of Director Grisbbs correspondence dated Febsuary 2,2011.

I have reviewed the reforente Stipulations identilltd in the enclosure listing thestipulation, that were entered into with the Board, I have also heel the opportunity to review Thecorrespondence andthe listwithDebm Sheffer,the DeputyBxeoutiveDireetoroftloaNevadaSt&eeBooed of Dental Examiners, As arsenic of our reviewthefollovdng resposte is olfrrcd.

As to the acipuletiosos entered into with fouowing

1. Xlyo Benjamin, (Action Date: 06(21/2007)2. Grcguey Bowotes,, (Action Date: 03/13(2008)3. Sebastian Glaze, (ActionDate: 01/17/2008)4, FrenkNguyen, (Action Date: (Action Date: 03/18/2108)5. Bradley Rowe, (Action Date: 06(21/2007)6. Adrian Ruiz, (Action Dare: 10150/2008)7. Mohammed Soltani, (Action Date: 01/17/2008)8. Samuel Thomas, (ActionDete: 11/01/2007)9. Liem Vu, (Action Date: 01(2412006)10. SufiaWali, (Action Date: 06(27/2008)11. Daniel l’atk, (Action Date: 05/0212008)

Cynthia Gnsbba, RN., S.D., DirectorMargarita Meralea, Compliance CeordiontorDivialon ofrraellttoner Data DenIesMarcIa 3, 2011Page 2

In determining whether or not to report those actions as adverse actions, ChapterE Reportof the NPDB guidebook E-24 dated September 2001 was considered which is attached kr youretkrence.

None ofthe stipulations indeneifled above (I’ll) resulted in either e fine, revocation,suspension, censure, reprimand, probatioaenor wee there a stsrrenderofliceeeere pendingdisciplinary action, hi addition, none of the settlements indcntified ebtve in any viny restrictedthe dentiatpractice. Therefore itia ouruaderstandlogehe Stipulations (1.11) identifledabove weeenot adverse actions, but were corrective actions not require repoeting. Please advise asto whetherocr mderatanding ia correct.

Also be advised the BESA guidelines issued on Febeusry 25,2010, effective March 1,2010 have been taken into coessideretion for way aetionsieken alter Mardi 1,2010. 1 note thatnone ofthe stipulations ideeseifled iii the coerespondence involved stipulations that were cateredinto the Beard stsbacepscut to Match 1.2010.

As to the actions listed below (1.5) according to The Board’s Deputy Executive Direceor itis her recollection during the applicable time frames she submitted tempoesey adverse ectiuureports with the understanding these temporary adverse action reports would automatically beconverted to pem~enant advesse reports. After review your correspondence it eppeacs thefollowing actions below west not converted into permanent adverse action reports. The DeputyExecutive Director now knows Sr is her responsibility to convert temporary adverse ectien reportsto permanent adverse aceion reports. Therefore the Board’s Corrective Action Plan will be tosubmit adverse ‘client reports on the dentist listed below withie fifteen days ofaubmiasion ofttoiscoereapendeatce.

1. Duff Ksater, (Action Daee: 01/24(2006)2. Todd firempel, (Action Date: 10/30/2008)3. AsinLousing-Nont, (Action Data: 06/2112007)4. Tn Nguyen. (Action Dale: 01/24/2006)5. John Vennoebl, (Action Date: 06(27(2008)6. Gerald Rarnpton. (Action Data: 11/09/2006)

~t’5 R,part, 5005 Ootdteak -

ReportiogAdverse LicansureAtlons

State madical and dental licensing boardsnrsstrtpnrt adverse actions againstphysicians and dentists to the NPDBvdtht,a0 days from cite data an adventliceisnuce 501100 was taken.

State mndimi and dental boards mastrcportto ate, NPDB restate disolpihasyactiniss related to professional ccsspettnenOr profasgtorsal wadsite takes against tonlicenses of physician, or doatista. SuchIlgensura action, include rnocatins,auspensios, censure, rr1srim.nd, probation,sad surrender, State medical and dentalbonnie must also report revisions toadveras liocantare actions. such sosalnatatamnot of a license.

Effective Dale ofActioa

An Advano Action Report must besubmitted within 30 days oflito date oftheformal approval ofthe Ilcestasre action bythe State medical or dental board or Itsauthorized official. Sigallient dalsyn may

occur betactn the formal approval oftheaction arid lbs drafling of lisa order forpublrta5les~ however, tine bigger datafur reporting lbs adverse action in basedon the board’s formal approval ofthn,ethos.

llxamplesofRepartabla Aclinna

The following advnse liconaure athena,when related as also professionalcomptinica or ptofcatmnnal co,sdnae ofaptnyaicinn or dmtlaa, must be reported tothe NPDB:

• Denial of as appleatlon for licenserenewaL

• Withdrawal ofno applimtioe forlicense renewal (should ha reported asa volasniacy sisarandu).

• Ltonssuro dtseipilosry action lakers bya State board againat one of itsilcenstaalappticsnas for Ucasatarerenewal based upon a llenrsuradisoipilnaayaatloa, related to theprnciitinner’n professional competenceor professional conduct, taken byaaotbnrSateboard.

REPORTING ADVERSE LICENSURE ACTIONSCynadhia Grubba, 524., LD,, DirectorMargarita Morales, Compliance CoomliasntorDMsiosn of Practitioner Data BanksMarch 3, 2011Page 3

Lastly aa is relates to Todd Keospel (Action Date: 04/01/2008) nccord’mg to the Boardrtcords ass adverse action was filed with the National Practitioners Data Bank on April 18,2008,DCN #5500000050588173.

I hope thin correspondence baa answered all of the inquiries set forth rn yourcoesespondtrtoe. If you have any further questions, please o not hesitate to call.

JAH:pcEtsclusltrus as Statedcot Kathleen Kelly, Executive Director

Debra Sissifer, Deputy Executive Dircctor

CopterCeroar

10erasESaran

5-54 tnpcesbnsart

Enmj,lac nINes-Reportable Acitoas

Tine following edverac licenrore actionsthoisid sotbe reported to the sPED;

• Pines cod other monetary sandbarunaceompanbed by other liceeriursaction, web an revocatIon, suspension,censure, reprimand, peoballon. orsurrender.

• DenIal ofltn InitIal application forlicense.

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action Thkcn by 4’. A eeti1emwsca~reameaewhiels ImposeraSisto board bared opera tine monitortng ofa practitioner (ciapraclidocur’a deliberate failure it speclflopsulod oftimo. rmims suchr~porttlIconsure dl clplinnap action monitoring ronodeirten .rtrteiceion ofrakereby another Oteta board, when a (be peeroltlonor’s listens or Isreport ofruehacdoe krequmtcd o~c considered lobe a reprimand.liceessere renewal appucniron.

A liconrerne disoiplinacy aelion whichesando(herenonalarynnctiona i~iila”aa,’pending

aeeonwwsltdby other tloasnejra anton, . cosnplstlon ofepeclfinprograins orsuch as rcvooabos., anipenniot, actions. flowover, if a e~yn of aecosenra, reprimand, probation, or disciplinary action in eccosepanicd byuiurcodnr. . stion, the probation is rtportable.

Voluntary relinquishment olephysiolen’s license for personalrersossnot related to his or herprofessional coespetenco orprdfernlonal conduct (for exempts,neturraest).

• Licensnnrt actions taken against neon-physician, oon.deceist health curepruetitloners.

I-,

5.p’emb,r note

(4 DErnUSBNT OF HEALTH a, HUMAN SERVICES Health Rassureas and Sar4ces Admlriotmtisn

Bureau ofHetlthptafesaions Asck~iIe. MD 20857

MAY 27 2017NAY 2 5 2011

Ma. KoelileenEellyExecutive DirectorNevada State Beard ofllental Exemirseen60105. Rainbow Boelevasd, Suite A-IUs Vesse, Nevada 89118

DeorMa. Kelly:

On behalfof the Health Resources and Servicas AdminIstration (ERSA), Bureau eflleolthProfeanions,Division nfPnctielousrData Boantes (D?DB), Iwould like to ihankyou arid yoer erganiaafioir for thesupport and aonistaneeyou provided dusing our eeceot Myorse Lieensoro Antion Comparison Project. Theprojeetprovided fiaraoompre~eeslva eaviow ofpubltoly available records ofadveree ardors agaiset thereports in the Natioset Peacti anorData Bank (NPDB) and Health Integrity Protection Data Bank(UIPDB), cotlestlyrly Imoven as the Data Bank”

During the past year. we requested that your organimlion revIew end recoarite certain adverse actions fortheycasa 2006-2009. Ourrcvirwrevealed tbatoheaelionein qaasfiothbaddth etbeenmpnncd, orwera‘meoaTertlyrepoetedtotheDatanank As a dlreetresultofyourpartioipatlonih this reeonefliatlonprorese,you have fiartlacred our national efforts In ensure that the lofonnation in the Dais Bank is accerate,complete, and avallalle.

We eommendyourorganizationfnrthnsuecms ofthlaeffort. BymccdngthoDaaBaskreprcthsgrcqufrcmrnta,yeurorganizadonleas attained CorssplisnP status, Thereralts ofApril 1,2011, AdverseLincnaure Action CnirerartsenProjer~ alengwlth updates on other compliance efforts arc posted on DataBank webeife at hlo1/www endb.h’mda&acsovlrawthasod3swtaaunSur,ce.w,

Should you requise ad&oiosnl assiulsnco on Data BasIc reporthig requfrerneasts, please visit our webtite atbtto’(/www.nocth-lsiodb,henanvfh,dsxjeo. The websito contslss the statutes and regulations that pertain topeporting reqekemenlt, as well as fact siseeta and rtspons~ so 4’Askq4 Questions tat may guideyouq efforta.You svsyetet~cçs,tapfjI,ecuaeonierses,jeb Ceotoa’*t(000j 7~74/$2~bç hdt~nndbhinislajeofasny. &n~noaoton*offieedusvctlS, at (btl) 443-2lOltoreqdestàaslstancce

TheDcpaetsnent ofHeslthand Human Servlcea Is dedicated to pausat safety for all nitizons. We appreciateyourongoingefforis toktcpyourBoard’sreportieigcunentwiththo DaeaBask We Iookforward enworldsgwithyoc againinthe fissure, endwetankyouforyourfiell comnitoxot topalicntaafetysndhealth earn axcallanra, - -

Sincerely, -

pDivision ofPreodtioner Data Banles ‘ aL__i 1. 1.1 t.~ j

The Data Bank - Reporting Compliance Page 10179 The Data Bank - Reporting Compliance Page 23 of 79

Health Care Organizations

Reporting

Reporting Compliance Status of GovernmentAgenciesU.S. Department of Health andEuman Services (LIES), HealthResourees and Services Administration(LIRSA) has undertaken efforts to improve the completeness and accuracy of data reported to theHealthcare Integrity and Protection Data Bank (HIPDB) and the National Practitioner Data Bank(NPDB). The Secretary of fINS is exercising legal authority as defined tinder Section I l2lE(b)(6)(B) ofthe Social Security Act to publish a report listing Government agencies that have failed to meet theirHLPDB reporting requirements.

For more information about the reporting compliance process and definitions of terms, see A~ala~Reporting Compliance.

The following tables include the compliance status as of December 1,2011 for Government Agonciescontacted for the Adverse Action Comparison Project and Never Reported Professions ComplianceEffort. The tables include only those States and professions that ERSA has reviowed or is currentlyreviewing. The compliance status listed in the tables are one of five possible determinations: Compliant,Non-Compliant, Workirm Toward Compliance, UnderReview, or Not Reviewed.

For this compliance effort HRSA compared publicly available disciplinary liceasure actions publishedon State web sites for certain yearn with data currently stored in the HIPDB. 1-IRSA contactedGovernment agencies with the results of the comparison and sent letters indicating which actions werenot found in the Data Banks and requested agencies review these and report as appropriate.

n View Status of Comparison Project~ICY~ND~

thc.DataBankNATtONAu PttACrlTlONEltItt_ui’ cart NrtGttr~ ,, pIso,rcr;os

Allopathic and Reviewed ReviewedOsteopathic Compliant Compliant Compliant Compliant

Physician U Under Under WorkingAssistant Review Review Toward Compliant Compliant CompliantCompliance

Under Under WorkingPodiatrist Review Review Toward Cnmpliant Compliant CompliantCompliance

Under Under workingToward Compliant Compliant ConipliaotPsychologist Review Review Compliance

NotSocial Worker Reviewed Compliant Compliant Compliant Compliant Compliant

Bscktn TopStatus Status Status Status Status Status

I~JS~ asof asof asof asof asof asof7/1/2010 10/1/2010 4/1/2011 7/1/2011 iO/li2011 12/1/2011

Not Not Not NotChiropractor Reviewed Reviewed Reviewed Roviowed Compliant Compliant

Not Not~ Reviewed Reviewed fl ~.rii~’t ~}!1J~Nursing Working WosldngRelated Toward Toward Compliant Compliant Compliant CompliantProfessions Compliance Compliance

Not Not Net NotOptometrist Reviewed Reviewed Reviewed Reviewed Compliant Compliant

UnderPharmacist Review Compliant Compliant Compliant Compliant Compliant

WorkingPhysical I Not Not Not Not Toward CompliantTherapist Reviewed Reviewed Reviewed Reviewed Compliance

Physician - Not Not Compliant Compliant Compliant CompliantAilopsthie Reviewed ReviewedPhysician - Not II Not Compliant Compliant Compliant CompliantOsteopathic Reviewed ReviewedPhysician Under Compliant Compliant Compliant Compliant CompliantAssiatact Review

Under UnderPodiatrist Review Review Compliant Compliant Compliant CompliantUnderPsychologist Review Compliant Compliant Compliant Compliant Compliant

Under UnderReview K Review Compliant Compliant Compliant CompliantSocial Workeras of I as of as of as of as of as of II

~ Status I Status Status Status Status I Status IIProfessions 7/1/2010 10/1/2010 4/1/2011 7/1)2011 10/1/2011 12/1/2011

http://www.npdb-hipdb.hrsa.govfnews/ieportingCon,pliance.jsp 6/27/2012 http://www.npdb-Idpdb.hrsa.gov/news/reportingConiplianee.jap 6/27/2012

Occupation/Field of Licensure Codes Page 1 oft

entity: NEVA~ &ME BOMO CF DENIM. EXMeNERS 11.48 VEGAS. W~ Usen Kegebtl4

OCCUPATION/rIELD or LICENSURE CODES theD~-f~~~p4ç}IEALTI4C4SE IIiTeGKflV & PEOITCTION

Please select the code that best describes the subjects ecospatenat activities cc acensure categoryeascoatad with theaaceeisejactl~etng reported.

C Physiciano Nurse - Advanced, Registered, Vocational or PracticalC Nurse Aide, Hone Health Aide And OtherAideIs Dental Service Practitioner

o DentalC Dental Resident

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Exhibit 3https://www.npdb-hipdb.&ao.gov/aervlet/B]anI~eportFormServlet 6/27/2012

Code ofFederal Regulations (CUR) re: the NatiooalPraetitionerDataBank(42 USC 11101-11152)

Regnlatinn section Discussion/Comment45 GIlt 60.3— Definition As noted below, this phrase adversely affecting” is

used at 45 CER 60.tl(a)(i) regarding action taken by aAdversely affecting means reducing, restricting, health care entity that mus, be reported to a Board.suspending, revoking, or denying clinical privilegcs or discussion below.membership in a health care entity.

It is inspomant to state, that this phase ‘adverselyaffecting” is not included in the specific iypes nfactionadelineated to be reported by a Board to the NPDB, asreferenced at 45 CUR 60.8. Sec discussion below.Moreever, tire definition of “adversely affecting” onlyincludes reference to clinical privileges or membershipin a health care entity. Again, the definition does notinclude any reference to a license issued by a Board.

45 GIlt 60.3— Definitian This definition is imporlant because there is a specificreference to “Beard” which includes a Board of

Booed of Medical .Exantiners, or Eoard~ means a Dentistry. This becomes important later when lookingbndy or subdivision of auth body which is at the oilier various sections regarding what and who hasdesignated by a State for lisa purpose of liceasing, an obligation to report cerIum action but tot othermoaitoring and disciplining physicians or eleneists. action.This terna laelndes a Board ofOsteopathic Examinersor its subdivision, a Board of Dentistry or its See for example, 45 CUR 60.~, as discussed below.subdivision, or an equivalent body as determined bythe State. Where the Secretary, pursuant to section423(e)(2) of the Act, has designated an alteestate entityto cany out the report’mg activities of §61.11 due to aBoards failure so comply with §60.8, thu tense BoardofMediesl Examiners or Board refers to this altemateentity. (Bold emphasis added.)

45 CUR 60.3 — Definition It is important to note that there is a definition for“State.” Because, at a minimum, there is a definition of

Stole means the fifty States, the District of Columbia, “State” and a definition of “Board” and the daftn’ftinnsPuerto Rico, the Virgin Islands, Guam, American are ohviottaly different, it becomes imporssant later whenSantos, aitd the Nortisem Mariana Islands, looking at the other various sections regarding what and

who has an obligation to report certain action and notoliter action.

45 CUR 603— DefinitionThis definition of “negative notion or finding” becomes

Negative action or finding by a State licensing important because it is used in certain other sectionsauthority, peer review organization, or private below but NOT other sections below.accreditation entity means:(a) A fmsl determination ofdeniai ortemaination ofuss Importantly, at 45 GEls, 60.8 wltielt specifically dealsaccreditation status from a private accreditation entity with what licenstsre actions taken by Boards Iltat Boardsthat indicates a risk to the safety of a paliesst~s) or insist report, it does not reference “negative action or

Regulation section Disrussion/Commentquality ofhealth care services; findings.” So, Boards, pursuant 45 CFR 60.8 are not(b) Any recomsnendation by a peer review required to report matters falling under the definition oforganization to sanction a health care practitioner, “negative action or finding.”plsysieiao. or dentist or(c) Any negative action or finding that under the Rather, as toted at 45 CUR 60.8 (sg~ discussion below).State’s law is publicly available information and is the Board is mandated to report to the NPDB only threerendered by a licensing or certification authority, 3 types or categories of action, None of’ those threeincluding, but not Iituitcd to, litatitationa on the scope specific subsections found at 45 CUR 60.8 is thereof practice, liquidations, injunctions and forfeitures. reference to the phrase “negative action or finding.”Thia definition excludes administrative tines orcitations, and coereceive action plans, unless they are:

(I) Connected to the delivery of health careservices, or

(2) Taken in conjunction with other licensureor certification actions tacit as revocation, suspension,censure, repritnand, probation, or surrender.

45 CFR 60.5 - Whcn informatioit moat be reporteel.45 CUR 60,5(b) provides that Boards are to submit

Information required under §~60.7, 60.8, and 60.11 int’oonation within 30 days. It should be noted sltntmust be submitted tn the NPOB within 30 days nowhere does this section dealing with what a Board iafollowing the action to be reported, beginning with to report does it state a Board it to report “negativeactinna occurring on or ufler Septeutbtr I, 1990. and action or findings.” This is important because, asinformation required under §~60.9 and 60.10 must be addressed below regarding 45 CUR 60.5(c), the phrasesubmitted to the NPDB within 30 days following the “negative action or finding” is specifically utilizedaction to be reported, beginning with actions occurringon or after January I, 1992, as follows: 45 CUR 60.5(c) is important because it apecilicully uses

the phrase “negative action or finding” witicts, as noted(a) Mcdprreceice Pcsynsrnss (ff60. 7). Persons or entities above, is defined in the “definitions” section footed 45must sttbmie information to the NPOB witltin 30 days CFIt6O.3.froto tlte date that a payment, as deacribed in §60.7, ismade. If required under §60.7, this infomtatiot, tsaust More ttnportatatty, it should be noted that withbe subtnifted simultaneously to the sppropr’sate State respect to “negaeivo uction or fusding,” 45 CUR 60.5(c)ticeasiag board, requires “[pleer review organizations, or private

accreditation entities must report any negative actions or(b) Licensure Actions (ff60.8 and §60.9). The Board findings to the State within IS days from the date elseof Medical Examiners or other licensing or certifying action ivas takeit or Use finding was nade,”autitority ofa Slate must submit information witltit, 30days from the date the lieensurc action was taken. This can be seen as significant because it specifically

does note mandate a Board is to report “negative notion(e) Negative Action or Fi,tding (,f60.IQJ. Peer review or finding.”organizations, or private accreditation entities tnustrepert any negative actions or findings to the State Also, sIte reports of “negative sction or fissditsg” takenwitltin IS days from the date the action was taken or by peer review orgattications or private accreditationthe finding was made. Each State, tlsrough the adopted entitles are to be reported to “the State,” Again, assystem of reporting, must submit to the NPDB the noted above, “State” is deflited as something differentinfonoation received from the peer review titan “Board,”organizalioa or private accreditation entity tvilltin 15days froto Use date on which k received thisinformation,

Regulation section Discusnion/Comment

(d) Adverse Actions (56011). A health care entitymust report an adverse action to Use Board within tdays from the date the adverse action was taken. TheBoard must submit the information received from ahealth care entity within iS days from the date onwinch it received this infonnation. If required under§60.11, thia informatinn must be submitted by theBoard simultaneously to else appropriate Statelicensing board in the State in which ttte lteatth careentity is located, if the Board is not such licensingBoard.

45 CFR 60.8 Reporting Ileensure actions taken by This sertion mandnecs what a Board is to report. ThisBoards ofMediral Examiners. section specifically sets forth three (3) categories of

action by a Board which must be reported.(a) Wbat actions must be reported. Each Board ofMedical Examiners mutt report to the NPDB any tt is important to note that nowhere in 45 CFR 60.8action based oct reasons relating to a physician’s or (again, this is the section which specifically pertains todentiat’s professional competence or professional what a Board is to report) does it use ehe phraseconduct: “negative action or finding” as defined at 45 CER 60.3.

(t) ~V1sieit revokes or suspends (or otitenviserestricts) a physician’s or dentist’s license,

(2) Which censures, reprimands, or places onprobation a physician or dentist, or

(3) Under whids a physician’s or dentistslicense is surrendered.

45 CFR 60.9 Reporting iicensure actions taken lay This section deals with what actions taken by a StateStates, that must be reported. Again, as noted above, “Staee” is

defined differently from “Board” and, as a consequence,(a) What actions must be reported. Each State is this section does not pertain or relate to the Dentalreqaired to adopt a system of reporting to the NPDB Board or actions that it may take.actions, as listed below, which are taken against ahealth care praetilieaer, physician, dentist, or entity (as Also, with respect to 45 CUR. 60.9(a)(4), while itdefined in §60.3). The actions taken must be as a references the reporting to a State ‘negative action orresult of fonsiel proceedings (as defined in §60.3). The finding” it relates to only “negative action or fmding”actions wtsicls must be reported arc: taken by entities oUter than a “Board,”

(I) Any adverse action lakes by the licensing authorityof the State as a resole of a formal proceeding,including revocation or suspension of a license (andthe iengtit of any such suspension), reprimand,censure, or probation;

(2) Any distnisssl or closure of the formal proceedingby reason of the heailh care practitioner, physician,dentist, or entity surrendering the license, or the

Regolaeion section Discussion/Commentpractitioner lcav’mg the State orjurisdiction;

(3) Any ether toss of the license of the itcaitis tarepractitioner, physician, dentist, or entity, whether byoperation of law, voluntary surrender (excluding thosedue to non.payment of iicensure renewal fees,retirement, or change to inactive status), or otherwise;and

(4) Any negative action or finding by such authority,organization, or entity regarding else health carepractitioner, phyaiciass, dentist, or entity.

45 CFR 60.10 Reporting negative aceinos or This section deals with what actions taken by peerfindings taken by peer review orgairizationa or review organizations or private accreditation entities.private accreditatIon entitles. Again, as noted above, peer review organizations or

private accreditation e’stieiet do not fall within site(a) What actions must be reported. Each Slate is definition of “Board” tisd, tiscrefore, this section doesrequired to adopt a system of reporting to tire NPDB not apply to a Board.any negative actions or findings (as defined its §60.3)which are taken against a heaith care practitioner. Also, it is insportant to note chat this section sets forthpisysiciats, dentist, or entity by a peer rtview what action is to be reported by peer revieworganization or private accreditation erstity. The health organizations or private accreditation entities. Insteadcare practitioner, pitysicieo, dentist, or entity must be of listing three (3) specitie types of actions witich causelicensed or etherwise authorized by the State to be reported, like witis a Board an found at 45 CUR. 60.8provide heoltls core services. The actions taken mtsst as addressed above, this section instead requires peerbe as a result of formal proceedings (as defined in review organizations or private accreditation entities to§60.3). report “any negative actions or findings.” Again, it is

intporeant to note ttsst etsis pisrase (“negative actions orfindings”) is used here in this section but is not used inUse section dealing wills what a Board is required toreport.

It is important en note if a Board was required to report“negative actions or fusdings” tlsen the reguiations couldhave mandated such a requirement at 45 CUR 60.8.They do not mandate such of the Board. Therefore, theBoard is not required to report “negative actions orfindings” (again, as defined at 45 CUR 60.3), antike peerreview organizations or private accreditation entitlea,which are required to do so pursuant to this section, i.e.,45 CFR 60.10.

45 C1t’R 60.tt Rtporting advtrst actions on clinical Tlsis section nsandaltn what actions taken by a “heathprivileges, care entity” (which is also defined at 45 CUlt 60.3) must

be reported to a Board.(a) Reporting to the Board of Medical Examiners —

(t) Acliotss that must be reported and to whom the This section does not deal ‘vitis what action by s Boardreport must be made. Each isealils care entity must must be reported to the NPOB. Those reqsiiretnenta arereport to the Board ot’Medicat Examiners in the State noted at 45 CUR. 60.8.

Regulation section Discussion/Commentin which the health care entity is located the followingactions:

(i) Any professional review action that advertelyaffects die clinical privileges ole physician or dentistfor a period longer sltan 30 days;

(ii) Acceptance of the surrender of clinical privilegesor any restriction of such privileges by a physician ordentist—

(A) WltiIc the physician or dentist is underinvestigation by the health care entity relating topossible incottspetetsve or insproper prnfesaionalconduct, or

(B) In return for not conducting such an investigationor proceeding; or

(iii) lo the case of a heatth care entity which isprofessional society, when it takes a profetsionnireview action concerning a physician or dentist.

SMohn.H\Raleighs Httns\014127 Dental Dosrd\TABLE RE45 CFR6O - NPDB.dccx

Exhibit 4

Exhibit 4

Code ofFedenti Regulations (CER) Ce: Healeheare Integrity and Protection Data Bank (42 usc 1320a-7e)

Regulation section Discussioalcommeut45 CFR 613 Definitions. It is important to note that the definition of “any

nthcr negative action or finding” specifically statesAny other negative action or finding by a Federal it “excludes administrative fines or citations andor State licensing agency means any action or corrective action plans and other personnelfinding that under the State’s law is publicly actions, unless they are: (I) connected to theavailable information, and rendered by a licensing delivery of health care services, g~ (2) Taken inor certification authority, including but not limited conjunction with other licensura or certificationto, limitations on the scope ofpractice, liquidations, actions such as revocation, suspension, censure,injunctions and forfeitures. This definition also reprimand, probation or sun-ender,”includes final adverse actions rendered by a Federalor slate licensing or certification authority, such as Therefore, in keeping with this definition andexclusions, revocations or suspension of license or its exception, it goes without saying that thecereificatiun that occur in conjunction with stipulated agreements for corrective action enteredsettlements in which no finding ofliabilily has been into by licenacca mid the Dental Board aremade (although such a settlement itself is not corrective action plans which do NOT fall withinreportable under the statute). This derinieton the definition of “any other negative action orexcludes admtntstraeive flees or citseious and finding.”corrective aceion plans and other penonaelactions, unless they are:

This definition and it excepeion for corrective(I) Connected to the delivery of health cure action plans is importast alan hecause itservices, and specifically includes corrective action plans

(assuming they meet the two (2) sub-requirements)(2) Taken in conjunction with other Ileensure or as being excluded from being defined as “any othercertification actions such as revocation, negative action or finding.” Thus, sueii a correctivesuspension, censure, reprimand, prohatinn or action is not required to be reported.surrender. (Emphasis added.)

Also, tltere is an issue regarding wheeher aBoard even falls under the definition of “Federal orStatc licensing agency” in light of a Board’srequirement to report under the NPBD (as opposedto this data bank the HIPDB).

45 CFI1, 61.7 Reporting licensure actiont takenby Federal or State licensing nnd certification This section mtndates what “Federal or Stateagencies, licensing and certification agencies” are to report to

the t-tWDB. This section specifically sets forth(a) What actions must be reported. Federal and three (3) categories ofaceion by a “Federal or StateState licensing and certification agencies must licensing and certification agencies” which muse bereport to the HIPDB the following final adverse reported.aeeions that are taken against a health care provider,supplier, or practitioner (regardless of whetiser the It is important to note Iliac nowhere in 45 CFR 61.7final adverse action is the subject of a pending (again, assuming the NIPDB pertains to a Board)appeal)— does is use the phrase corrective action.

(I) Formal or oflicial acsions, such as revocation or In fact, as noted above with regards so thesuspension of a license or certification sgteement definition of “any other negative action or finding”

Regulation sectioa Diseuasinn/Cnmmentor contract for participation in Federal or State it specifically statea it “excludes sdministrativoItealtis care progrmns (and the length of any such fines or citations and corrective action plans andsuspension), reprimand, censure or probation; other personnel actions, unless they are: (I)

Connected to the delivery of health care services,(2) Any other loss of the license or loss of the ~gg~ (2) Taken in conjunction with other licensurecertification agreement or contract for participation or certification actions such as revocation,in Federal or State health care programs, or the suspension, censure, rcpriinastd, probation orright to apply for, or renew, a license or surrender.”certification agreement or contract of the provider,supplier, or practitioner, whether by operation of corrective action stipulations as used by the Deniallaw, voluntary surrender, non-renewal (excluding Board can thus be seen as falling with’us thenonrenewals due to nonpaymene of fees, retirement, exception eo “any other negative action offinding”or change to inactive status), or otherwise; and and, therefore, are not reportable pursuant to

61.7(a)(3). Again, even if the reporting(3) Any other negacive action or finding by such requirements of the NIPDB apply eo a Board. AsFederal or State agency that is publicly available noted above, there is an issue regarding whether ainformation. Board even falls under the definition of “Federni or

State licensing agency” in tight of a Board’srequirement to report under else NPBD (as opposedeo this data bank, the Hlt’DB).

E The ‘ftlJ’DD Guidebook” stales at page E-l0, iii part, for examples of what is NOT REPORTABLE toX I 1 the Ecnustpies oJWon.ReportnbteAcdiwtx

The fotowing adverse licenaste actions should tint he reported to Itte tIIPDI3:

A scttlcnient agreement whtch im~tea the noitiloriag ofa practitioner, pnnvider, or sspptics- for aspecttic pcnied oflinin, utica audi itiositttitig cotintilulna a tetleiction on tine licensee. or is consideredto ha a rtpnmsad.

ham is consistent wiSh the Board’s use corrective action stipulations wisicis havo either no additionaleducational component and/or meoitoring component. Such a stipulation for corrective action by theBoard does not constitute a restriction on the licensee and/or is not considered no be a reprimand by tiseBoard. Thus, such a stipulation for corrective action is NOT REPORTABLE.

The above is also consistent with a power point presentation by Cynthia (‘nruhhs, RN., S.D., ensaddreaued below:

Power Point presentation “NPDB Rcot,rtinec When to Reoort & When not to Report”

NPDB Reporting

When to Report & When not to Report

Cynthia Grubba RN., JO,U.S. Ongoitmarit en Health and Human SnnilcesHealth Reanarens and senilens Admtslotrston

Osinais 01 Health PtntessiansDivision 01 Ptnsstlennn Data nanan

Timothy 8. AdelmanAdnlmss. sent & Satits, U.C

NO’L’E: Ms. Gruhbs is the person who sent to the Board a letter in May 2Ott stating the Board wasin compliance with the data banks’ reporting requlrensente. The May2011 letter f,’om Ms. Grubhwas amos AFTER a letter was sent on behalf of the Board dated Match 3, 2011 (responding to a

h February ZOtt letter from Ms. Gruhht), advising and discussing, in pare, correctivo actionE stipulations which were not reported to tha data banks. Again, Ms. Grnbbs’ May 2011X determination tlte Board was in compliance with the slats banks’ reporting requirenncnts Caine

AFTER she was advised of the Board’s reasoning and basis for its one of correctives actionstipeiatlons and why they were not reported to tIne data banks. -AFTER reviewing this infoi’maeioa,Ms. Grtsbbs’ May 2Ott letter advises the Board it ~ in compliance with data banks’ reportingrequirements. This determination by Ma. Gcusbbs that the Board is ins compliance with its reporting to

tim data banks is confirmed by lIce data banks wtbsito which notes Nevada, Dentist, as being Compliant”for its status ascf4/l/201 1,7/1/2011,10/1/2011, and 12/1/2011 (the latest date referenced). * With regards to whether the action in Scenario 2 was or was not reportable. Ms. Grubbs’ power

point presentation states:

* Ms. Orubbs power point presentation includes reference to 2010 Affordable Cart Act (requirestht mergernfthe HIPDB into Else NPDB): Scenario 2

Background CJ~I~. RequIred Second Opinion

but Not Permission

The Data Bank is a result of 3 separate laws created NOT REPORTABLE — There is no restriction on Dr.at 3 separate times. Rodger’a privileges since she can perform the procedure

— Title IV of Public Law 99-SOD, the flea/lb Care regardless of what the second opinion says.Qua/fly /rrsprovenrentAcl of 1986 established the — If the practitioner was required to obtain concurrenceNPDO. with a second opinion before performing the

— SectIon 1921 of the .500/9/ SecunfrAct. procedure, than it would be a restriction on theSection 1128E of the .Soc/a/ SecuntyAct added by practifoner’s privileges and reportable.Section 221 (a) of thu flea/I/s Insurance Porlab//ify — Mandatory post surgical reviews are not a restrictionaodAccosin/ab////yAct of t996. on privileges and era not reportable.

The 2010M’ordabfe Care Ac?— requires the merger ofthe I-1IPDB into the NPOB.

— Execution of the data merge Is slated for 2012.This factual scenario regarding a requirement of a second opinion but with no requirement that thelicensee abide by or seek permission from a second opinion as being NOT REPORTABLE can be seen as* Ms. Grubbs’ power point presentation goes through various fisctust scenarios and then provides analogous to the Board’s use of correctivo action stipulations which have tuonitoring or educational

answers to those factual scenarios about svhetherihey need to be reported or don’t need to be reporeed. componenes. Under either scenario there is no resiriction on the licensee’s license/privileges and,

sherefore, the action it NOT REPORTABLE.* One oflhe scenarios (Scenario 2) is analogous to the Board’s corrective action stipulations whichhave a monitoring component: Review of other scenarios in Ms. Orubb’s power point presentation reveal that the overriding focus for

aceions that are to be reporied generally have a component where the doctor’s privileges arc restricted orScenario 2 attapended or there is deemed to be an adverse action.”

Htrc, wills respect to the Board’s use of corrective action stipulations whtch lssve eieher an additionalRequired Second Opinion educational component sad/or monitoring component, such action is skiia to the action Ms. Orubb’sbut Not Permission factual scenarios deem to be NOT REPORTABLE. Aflerell, an additional educational component and/or

monitoring component are not actions which remind or suspend a licensee’s license and suds action is notdeeused to be “adverse action:’ Hence, it is NOT REPORTABLE.

A surgeon at the Hospital began having an Increasedrate of complications following rhincpiasiles.The Surgical Advisory Committee at the Hospitaldecided that a second opinion would be required prior tothe surgeons performing a rhinoplasty.Wbile the surgeon was required to obtain a secondopinion, she could perform the surgery regardless 0fwhat the second opinion said,

~1l~A_i13 1t ~E The website svww.nodb-liiodb.tiraa.:o: h:sapag. regarding ‘May 2012 Newsletter.” Part of that pagehas a section entitled Dear Data Battle” which references questions about Data Bank policies andprocedures.

Ont oftise questions reada:

‘tf a State Board receives a complaint received shout a practitioner, nnd as Letter ofConcern is subsequently issued to the practitioner, would it be reportable to the DataBank?’

The response, in pertinent part, provides:

‘Some states consider a Letter of Concern to be a publicly available negative notion orfinding, thereby making it reportable. States thai do not consider a Letter of Concern tobe a publicly availabtt negative aceion or finding are ‘lot required to report the action.”

This “Dear Data Bank” discussion van be seen as elso supporting the Board NOT REPORTINGstipulation agreements for corrective action because it has been the policy of the Board for years thatcorrective action is not discipline, net an adverse action, That there is no Itmiting or restricting of thelicense, and corrective aceion stipulations do not impose revocation, auapenaion, censure, reprimand,probation, or surrender oflicense.

Moreover, it should sot be forgotten that Cynilsia Grubbs, ltN., J.D., Director, Division of PractitionerData Banks, has advised in correspondence from May2011 Die Board is in cotsspliance with its reporting.This dettrmination by Ms. Onsbba came AFTER site received a letter sent on behalf of the Board datedMarch 3.2011. advising sad discussing, its part, corrective action stipulalions which ‘veto not reported tothe Data Banks. Again, it was AFTER Ms. Orubb was advised ofthe Board’a reasoning and basis fur itause ofcorrective action stipulations and why they were net reported to the NPDB did Ms. Grmabb send herletter saying the Board was in compliance with the data banks’ reporting requirumcmtts.

Exhibit 6

E Other Boards usins corrective action arscementslorders and NOT REPORTING them Co the data banksCertain other Boards in other slates also use corrective action agreemcntslrrdrra and 00 NOT REPORT

For instance. the Texas Medlcnl Beard (TMB) states, in part, oil its website:

REPORTING DISCIPLINARY INFORMATION

TMB reports to the National Practitioner Data Sank all disciplinary_actions that piecerestrictions on a physician’s practice, as well as any suspension, revocation, or publicreprimand. TMB does not report to the NPDB actions that only place requirements onthe licensee, such as participation in a chart monitoring program, extra continuingmedical education, or an administrative penalty.

TMB disciplinery actions are also made public. Names and summaries of any type oforder approved by the board (agreed order, temporal)’ suspension order, etc) aredistributed In news reieases, published in the TMB newsletter, the Texas Medical BoardBulletin, and are included In the licensee’s profile, which is available through the TMBweb &ite. Since remedial plans are not disciplinary actions, they are made publiclyavailable on a physician’s profile, but are not reported in the newsletter or in pressreleases.

See ~vwsv.tmbaraec.ix.usleonsumer/DieciplinarvProccss. Olin.

Also, the Oregon Merlicnl Board uses “Corrective Action Agreements” which its newsletter/report notes~s rolIo~m:

Corrcctive Action Agreentents ate not disciplinary ordsrs. They are public agreementswith else goal or remcdiating problems in liccnsccs’ individual practices.”

‘Ike corrective action agrremenrs am not referenced as hcing rcponcct to the NPDB. In contrast, theOregon Medical Board aleo reference the use of’disciplinary orders” which are specifically referenced asbring reportable to elm NI’Dhi.

Exhibit 7

Further, the Minnesota Board of Dentistry referci,ces “Agreementa for Corrective Action” which arcnoted as ‘not considered disciplinary action, and therefore, is not reported to the National PractitionerData Bank” In particular, tlio Minnesota Board offlentistry’s website states, in pertinent part:

2. Agreement for Corrective Action.

Purpose: An Agreement for Corrective Action is used (1) to resolve complain~ whichaiiese minor violation(s) of the dental practice act, and (2) when the nature of the violation(s)does not warrant disciplinary action,

The Agreement for Corrective Action:

a, An Agreement for Corrective Action is expected to lead to dismissal.b. It Is not intended for long’ter,n monitoring or conditions (whereas a Board

order may piece limits or conditIons for long time periods);c. It Is a public agreement, but it is not considered disciplinary action, and

therefore, is not reported to the National Practitioner Data Bank.

See www,dentaiboard,state,tnn,us

NI’DIi-hIIPIJH WTBS1TE: ‘~~VW2~PDh3-iflpflh1cQM A- INTN000CIloN

The legisbuiers isrthaHlPDB ulases thaI them be:

Pmtnaice atipalsacy.

Civil labiliny protovairn.

Coerdiusatioss silOs tie Nosiness Praclitianuer Dab Sonic IN]’DBi

- User ices for discisnase of ba~onrn6s~

- Rcgnularecpouls (snot less than nucnthtnc).

- Diapute prucalnoer

Elaboration of liner provisions see found dnaa2lsoai isis Gsdulrhssok. Esptaasasion niche eetariies ofelsiE liabitsy psotertion. and NPDS cautsediestion tee isolsokd in due inlinashig seaSons.

Interpretanion of UIPDB Information

Thu purpesse aithe HIPDII is to combat stand nod obese in health insusrenee saId Inenith gauze delisei~ andeopeomelcqsaloyesae. iheHlPDll inpshsunllva lbgnineamthsamavsutoalesrnenthasaeceeoempneassistnaewefnpeacnilionotspeosideruorsvppticn’npasovlisssnnavbepeudent HIPI)Bhdcmmsi,a is issanded cube sued in connbinasien ‘sills isainnm,sisn Sea’s other sources (e.g. evidance ofcorentcempesmtre Ovoailr conliearsss rjaaahy heproveunentsiadisa peer recnensnnaninns,saitcasionefnninhngaedo~csiaweusdrcbsiendsipnwithcaiizationa)is maknngdssensannnaninssenennploymoaalrslialion, ondfscatise, or ieeumredeehoosa

The infaneolion in One HIPDB should sane otIs aSqi Goveimnens ugercies and health plans thai shoeascii)’ be a peebtess, with a pantaralar pcansinianefa lwasidafs cv sappliea’s penliotmanee. HIPDBinhineseatinnslsaatdsnsss lot usodasslsesole assists ofvaftisnofapnclisieoes’sjsnviden~uersnspplicn’sprofessions] credeatisk

Cosnllslenniolily ofi4IPDB Information

Infonmalcn reposed to she I4IPDB is cesssidened confidential and shall not bun dindosed carps asspecified in the HIPDB Tenulatnana et15 CFR Past 01. The rondidcesbl receipt, acute, anddtsctanastefinfcnnnaaicn in an esseunial issgnedieasl ofbslPouopenasians. Aoampnelsensivesstcwisyspsnann has been designed no paeans snsanipndssien of. anal access no the dana by urn astiesi slalforesiennal snurcesub the lagernet The facilby in which the HIPDB is housed meess Dm45 securityspecificosionne and the HIPOBs stair lean snndergene on in-deych hacignensed necsnisvinvesdgnnian.

NPDB-HIPDB WutfisifE, 9V’VW.NPIfllamPDB.COM S sNTnsoDualoy

Preface

This Gnisfchaoh is means no sense as a reassure fur users csfthe llealdscase laseguiss and Peososioss DataBasic 5SIIPDSI. lsisoscofansunsbem-efelletsso,iasfoms shss,eatslseaarconnsssvsav alaeusthelllPDll —sshassseqnstsqsocosnpla sciththernquirensnssseoablishedbysousien I l2ifioftheSaeda!Serunriu Are.die lonislaujon garroting the HIPDB. This Gssiaerbook eenmins infansnanien ens sise HIPDB Snotgnvmznnnbtaemncies lnnetsdise saw enfeerennno% health phmnn,nedheahhcannenedsiaeers,iraridesssend sunpplisn tutu nmdsoinseeseltsith the IIIPDIL

Foud ubtiens eaneening she H4PDBs tUbe rnblished hi theFedcmlRrgf eras] sails beoodihied as4aCFR lines hI. Ressuansibllsny for HIPDI1 innsslnssensauirn nesidm is line U.S. DepasanerssoiHesnsh andHsssnan Sections (051155).

The Guidebook is divided iso vend spiral seesions This nnsednicisn contains reseed hafamialk~nonthe llll~0H, slick inuluths is hisses7. the buss and eegnslanions Isis govern hand nthu inueosnaden firaathonzad snesa use Risible EasOsien sashes descuibes sIlo ouganicosiass sinai am eligible eqstnetra —qneesers. lion [1115DB Precsisioeens. Peac-idees, and Suppliers section defnses list sainjeans of cr150555ashmnierd so the HIpDS, and psavides basic encpisssasiarss alcoa HIPIJB ,alfssseies and sensorshsfcerasirnv lIne HIPOS Repeat neclieas hiesnlihes the buses of avlions — mass he neponnrd no die[IIPDII, and the Dispusies noclisns pens ides infrsnnalien as die Hll~DB dispute process.

Background

Healths ease Isaud hsardms thu Nasiouss~enomnosas tspanciai genus and deeatens health mre qnaalisy andpasiesstsnfe0. Rshirsnases efncossal losses due so sculls cam frard Inner feast Ssa ls)pxcmsrfatl healslscave eopendiussea-ber.seen 535 billion and Sloobiltiors banedun essissated lS97cspcnditaresnfnsareelsanSl Idllissy

The da’eulrh Insosssnssre PnenrhilmaesaiArenssnsoahilisy Aol ssfJSPsi llliPAA), Public Ease 104.191gentled Aa5sad 21. 996, reqssims the Seceetuve eiDliHS (Secresani, acing throash the Offuce oflsnpevbeGeneeaI(OlGlrfDHIISandthrUnilcd5rnses4uaseqOongunalnovanasanaflsanJlseal~ea~efrond and abase censanl pasgrnuun. Anneng Use nsajco conspeessass of this pnssasauss is the ecsainlistsn,csi of ananiasalduta bust so receive and disclose canals final adverse sedans aesient health cure psnclisioeavs.providers. and suppliers. iNs dais basic is knanann as the Healllscsre Insersiss end Psoiscisan Dana Bask(IIIPDB); sIne legislsainun “(dab buruglun also being also is refereed Ia an Stains I 121151 of the harm?Seesrthn Ac’ (Scums 1125(9.

Febeaasv 2Oni A-I

NPDB4IIPI2II WEInSITE: ‘nfl’5j04~nwuIponco’n A- g5iThOBUCTION

Persons orenthans sstso receive infarnsaien from the HlPDn eitherdbtrdyn-indisectharesnhdeestndue coefndcausnass peovisiosa ~Then sin Anshorized Agesais desihesasod as bandit HIPD5 queniesorrepass. lasts thn eunnisy and One sport are rcn1siised to unaiestamu ecnltdessialilv in ssccredansee simm HIPDBseqsirmseres.

The !‘HnsasyAra, I USC (552a, gnsssevls the conseens ofrederal ssssennsoireceenls tin individsals,lice sinew ceetsinnad in the HIPI)B, stein disclosure ssitlr,us she isdividsais toronTo. urdessthedisclosareisforavanerufthesossensafreceedsaspsubissednrsndlybsho;e&so!ReglaserThe published matins uses of HIPDB mnfusniuslios sin cot allnw diselaseunonhe geasenal public, uselirniled argus peonkinss uiivcnnvos I IzeSefdse SarkslSeesaiao-lce ssnssevoedc tIne dinelusurereu]uirensncnfaufuseFs-eedo,nq)ssjnrsna005,sAcs (P014)5 IJSCiIS2,asaesnnded.

The veoslidcraialisj psovisienan uiSecnhnn I 2851 da riot scam] ilasseligible rosily aseising ird’onnrationferns the Huron feasndiutisdng isleennasien In othens ‘also eee pan of sine isasnaigaslivus ar peer ieoiesspraeessaslengnss]ng infonsnattosisn.nedforuisepnupase Ivesulsiclsiasssupnesided.

One euample of the npyeogrisee use of 55515DB isfrnneniasu isa braids sIan lime diseleses theisfurss-aatre in moeisnd Sneer the ‘Upon no huttOn pbs airsuisls sns’5seeaibis fnr resiewisgachirrp000scsasapustivadanfeearnlianira In this case, both Sthealthpbeptrsausnelsshoeceeiu-cdoueinlissnaltens and die health pbn officials “Iso eahvessnennoy ues,icssed hdueiagdnecnsplounsosspvrressase oabjncs on she confidenublins peusidees rflflPDn.

The rensfsdeadnlbc provnuusn do eat upelv so due suigisal devsacenis or recode from ‘diets theeepmied inlimnahian kebtaised. The [IIPDUs coufsdenlisliss’ praviniegs do aol iusnpone all’ seascmfsdcnsialisveentummusmts mmsutsbessonthosedssouueeecsecrrrouds Thin- these emildendatiospnerhuisuusda eel her ce restates the release of the uondeulsicg doensnncva rrthe infamnanmmo itself, by therouivy miming she advensengliun. For enamplc. if n health plan that eroded as ndveese notion agahias achanojnnusoepernnasnnra the pnevisiesn of the H5PDU ueeeivau sssbpoena fcethr undealying records, is

‘sal refuse so seaside the eequeoed dsavunsenvs inn the grounds that HIPDB —. One release nitheeecenls or ivfaenns.sticnu.

Individual Isestdn ease pe ethinoess, pmvidas, cud snapplisrs ssbo obtain istnmasien about themselvesfrom theIOPDUnao pearnieed cu store dnuininrnranimssdin u’Innnesereseyeboeae

The stnoae eeqsaises the Seeeeeasy an assure hat ISPOB infeenatim ispeovidrd red usned in a namerOnacappmpdasely protean theernsfidesstialby of the hsfeenacunion nmldsepisauy nfisividsualsrcceirbnesmith cuaee services. Puricut nameunue nun so lsesubnuhlsed in 11115011 reparts.

Persons rrevtities sina recent isloumadan from thn hUron einlsee dineenly oe indirevuls ax subject sothe abuse cosfidnatalil’ puovivimaw The soluTe does not specify a pennatsy forsiatatheg the

Febnsau’sn 2niO A’2 Febrnaey 2501 — - 4-3

NPDB-mPDB WEIISITE; WlVW.NPDB.HIPOB.COM A. 201fl000UdflON

codidrntialilvprostissansoflhr HIPOB. Hononosno utho Pedeaal statutes may object bndialdnaln nealenhiliesna ninninat penalties, ineludlae rests and beiptinonmeot fan doe ioaptoopdalesaenvdlarlooaoeofHIPDB inimsoatirn,

ornciaj Language

meorneiaolaegoagaonfronwoa hEngilaltendtlldammdaorodaadmHlponmaubenoises in Faighsh. Donanoenra nebolued in may other bngsae ‘ill no be accepted.

Disclosure of the ]UP])B Information

Section 11221! Ibnits the disciosiare ollid’ennaaien iii the HIFDB. nov08 inlorotation is ansilable. uponreqaest,to:

- Fndcnl nird Stano Gnscnmteat agentries.

- Healila plans.

- heath care pnoctilionens. reindeer and suppliers regienning inlbrmado’a onecenbag thasiselces.

- Pennonseroegamizadenas requesting ief’nmtalicsl in a frroa anirielt deco aeopemrit doe idorduirationofony pantinalar patient on health cave practitioner, paobeohe. or sapplien

The limited ancess provision or Stoic,, I 2Db does roe allow the disslasnee oIHIPDB lafennaline inthe gernad pahltc.

Civil Liability Protection

The i,nnraetily ptocisiona bISection 11210 patted indisidaal.. enIia~ and thcir aistheotized agents frombeinehldlabledvilacdanlfrresnmkeatheHlpononlassthesisneaonealbea.aledgeorPalsiEs aNte htetonaf non. The sIahole pronidzotimgae itrusnothy to DII] IS ‘a aradnlainbta the HIPDB.

Coordination Ito (‘seen floe HIPDB aol] the NPDD

The NPDB is a rational hula baoaklltaa aol noablisbod ltaoaglaThle lVnfpeklie bran 99-660, thelfeaftlr Cmv QnooliGo fo,qn’aven,eotr dee oJ1996, as attseao]ed. It is ptbroeily ma alms or daggiopnoslnon iolerolnd to fanililale a consprdranaise nosiest nfhealth cam paeetidoroaw peafesaboalcredentials. ‘Dir SF03 acnsasacleanrnglnsme or ordornnaiion eolalingtcnnaedical malpractice paynrarets

Febrnary2000 43

onr004lIpoB WEDSrrE: W~flh2dIrOB~HIIODBCOM 8. ELIGIBLE EIPJITILS

~VhaI is an Eligibla Eadik?

Enddeneagiblelapanieipoie in the loroltlicate Into-nil and Pralectiaer Data Bosh (IlIPOBi are defrntdinthearrosiaiornerSectien I I2SEnfIIee&net&Sena-!o-dceaadhatheHjpnu PactlRolo. Diaihtceathmesrue responsible for n’aedng Section I 11gb rapoolijag aaofar qaa’niarg reqaintotrenits, en apinnpniole andmast cntil3 in “tiling then elitibilily an napaaltnaadbrqaerythelnPom.

TheIl]PD8paniiesinfrenoalienlaentalesnenlbndls!dtoalsas]ooeeetigibk:norceceicnlflpDBinknnssieerThe HIPOHcotecna infonnatian roeaedine ‘be no tend nrnifonaab tees. nelaa’oaa fis’as panicipsaicah,Yeriarat anol State health care psnnpeaon, eaiainal eusaviericon and cieiljudpnnrts tokoted tan health caresstInk Saclieo 11250 cenial as tim eapoetlog of anclu aderese aeliotrs diego ale canenaly no tltnrtdatnnvq101r’.lngreqeirenwntsnnneeinnedwislulhclllpoa.

Ta he eligiblere report to anrlfsor qaeay the I-SPInS, an enlist must be:

- A Federal or Linac Government agency.

- Ahoubdiplac

Each mdav is restiennuilnle Er deneonoiniag 0 eligibiliny a puricipeae in the gHost md mon cantor thouella ibihofla the HlI’DB in ‘suiting.

Defining Enliliet

Fedo en I or ala en U not, on nr coo Men et’

Fedenal or Slate (]ovmtgccrd agencIes indude. bosom tea lionisod le~ the foflasoduar

- Ilet’S.Dep’nulenteflastire(esp.theFedcnalleumcnueflnuesnigudgyate(t.S,AnoTnev,rheoragEnfnvctnenl Admininanation).

- ‘Sloe U.S Dvpaehnealofl-laatth and Hunnaa Senices geT, the Food and Dose a~dotiaiaWat5a~ ateIlealllo Care Financing Admicisaralien, tire Dilly ofloajaeclee Geneml).

- Any other Federal agree that eidieo’adminioeis o-pmcidea panacril — tIne delivery aiheald, cainserelee.. hoelad)og (lost am ‘baited 10) do US. Depantneoo of Defense sad the U.S. DepnrtanemofVereannu AlIbhs.

- FadeaalmdStsac bavcnlbneeaanlmge cies,inclsdingSuleuAeento~sGenonnlao,d bweofarearcnin000uineton (e.g., Canost’ and Diaaien Agonies.. Craonly i’etce Depaaarseeots~

Nl’Dle-HlPlale WEBsrrEa WSVW.NPOB-81P128,COM A. UTIRODUCrION

rod adverse actions labor actions the licotees clhticnl patnlneeo, and eoofesdeeaol sedmar menireoubipsofpdnnicisnandrndsos.and other licensed health gre, poacohioneot.

Teallns’iatel],ebnoeineouthene enoidantbaamsnnoepoetloboohthcHlPoBandNPofl,nsvrurnahasbear created Ioalleovsneeailvuharrao,q avontheaonn astnrrse alien tan both Dna Banks B stabnniathe repent oily once. ‘Ibis “mended Qnany’mg gad RqnnnbenSynrem (IQRS) is able to cord thenppenpnialeacaoninto the HIPDB, thnNPDI, reboot, Sinsitarly; etitinin aatheoioed taqnety bothData Beds hone the opdan of qoersing bdm the tnThB good due HIPOB whIt aaingleqnaysabadsnines

All final adnense action tabe,. an or ahee Aaguo Ii - 996 Idle dane Section I 200 was passed), mannbe rogneeled waite HIPOB, ‘lire BEFOG camlolaccept any repent with a dale cfnclinn oaken priartoAngttsa 21. 966.

User Peon -

Usee foes will he cloesged foe all qnecies for UPon lafomouricen eoobmbaed by n.un-Fe&eal agencies andhealth plans and far setPqaeeios sainnitnod by benlb°l cute loacnilionees. Presides. Oe anninbern. SectionI 212 050onpb Fenlenrnl enotiales freon pnyhrrn these reen. Refer 1° the SPOD-HIFOB usebsile for denailseecnedino be oop’eeot of HII0DB osec tests.

Febegan’ 2800 A-S

N]°IJB-BIl’OBWEBSITE: ~flVW!sT0B.HtPDRCOM ISELiGmEE E,N1TIThS

- State Medicaid Faced Canratmi Unite.- Fedenalar Slate ageatciea oscqtoosible for the licensing or cenilaarie,r ef beelth nato pnctitreoees,

providers and suppliers. lisanoples of such Scale agencies lorinda Uopoaaeeanra of PeafensioeatRepalador, ItrobA, Social Sen-men (hicluding Slate Stingy ned Cerlilcadan nod Mutlisaid StogieSlate anemias). Ceemneree. and Iamraece.

health Plan

The leann ‘ir~t plan” refers tea pius, praoearll or erttaaiealioro too prosideslrnoith berretitn sshetherditnclly am doooeb iosraaoce, pdaloannaoerro or otheesntise. roOtless out be recopoiged at “health plain’il’thev teeol doe teds caiteoloot ofptocblieg health bearers..’ I barth plans include, Its Cain net limited iou

- A palby ofbealth innoeance.

- A errtoaot eta nerniro bearEr ereanhenainr

- A meonbcathipagoeerotnissith ahealth rrarlntnsanee arganb’aaioaoeothcr pnpaid lnealth ptaa.

- A plan, pmornara. oeaproennese etiablidte4 ittairtslaeoi, or made asnflabla by an anopleyrtr em pinapofemploynes; a nnetitiaoeu’ peavider, Ce noppllar (intent a thimd’paaty adminientuanr, anmnteglniedheatdrcaee delinsrrvsvrseao;uot entploveesselfawaasosbden: apobiiason’ioegrenrpoeoogaaizsnion’,asrapeefensionalasneeiadaa.

-An hoateonre comlom~ itsnaance sensate, or ilosojesere ongrotlnripnrbao in licossied B nogoee in tireboasiseoac entailing healtlr note insosanen in a Sade, and ‘stitch is snabjeen to Sloe becuvhick eratoleteahealth ‘osreamtce.

boOth plans nay include drove plan binder] by Federal and Stale gnvvenetrcnrn, melediirg;

- lanedleate,

- 2-leegeafd

- Thn US. Depararrera of increase.

- Thc US. DepantanonielVeiaoaos AlTahT

• The Bnarua of India. .sdlhinlnogtainn.

Febenjan’ tslOt m-a Febeaaiy 2080 8-2

NPDIO-HIPDB ~VEBSITE; IVW’W.NPDB-HTPDB,COM to. ELICtULE EXITTIES

Reghterhtg whit the HIPDB

E*eriamreqdbte1ormeetiagscedaott2tEtererdtoanserqucg~.rqoi~tB tattErstot citteetly reolstered osith thy HWDO rcspeositdt fee deterotiatog thee eflgibitils Isolate teglateohogtoiththstHtpflfl, The] WfltaissoeoaDalatooS!deatiSeatiotNotrbertooto)aodopa,ossot.sodtueaolotorcasfialty tegisureed eatlils An costs that darn not have this iofcnootieot to oot aegittered ssith &HtPDB, Eutisytegiseatioep chnmosmar&.ohtain,db,’eottjtrtheNpDct.KtpDtl Help Lioeat t (800)767-6732.

Thecoraolidaoedytotiryat?rgtoeroitooaroroo dtrnestooegqnnbotuhaeceojstaforhoth&HIPDBand the >7DB, The mfoetaiion ooqttrnied ret this Ions provides lie 1110DB edth c&srodal itfonsotionceecer ring yo°w’etti~ . strtt as ocrot urzotieoo’n 0. addrras. Ped alTaspaoarc tdeotiteotieit Noaetboer(Tm:). and ossatonhipt your rrgsrlzstiro’s aadtrritv to padioipate in the’ It0011 tudor the NPDB underetch of the 000ates gowmlog the Data Bodas (Section t 220 for the HIPDB: tad ‘rote tv atd Sorliet1921 ofthr8ordnlyeetarnq.Arr forth l°DB);snrorosotsnjteln peinnaoyfoaooniontroerviccotd.forthose atohies audooneto] by tows, quay both Data Boda, whether qneoioa one to Ire sohesittead to theHIPOB etty~ to the NOtES rely, or to beth Data Banks, ‘ntis indeomatito utlo’ss the HtPDB to regidersnrmthv’ssshhodnticntopoatiripateiseHwDtltodeaenalmysusre~to’ntogj~ngcnd~jqsent,oreqairetttotttoarai restaictires, — to direct piece nod repros tespettlen npprupaiatety.

The EatriiyRegitrnorhoau Forto ntsocotealascatiftmtiot itfnlsss6enthattrtenhocompissedbvnneetftysCeroi&isg Official, The eooitfl Conifying Offichi eetdfes the terithtooy of the registration laditonniospresided to the CODS atniiar the Nt°DtO. The ceth(’on reunion tool cetbin an eeWoont hiS oinooaoereact,] nniesatare date. Fused, stamped, or pttoteoegiat sigttatcres ate teaceeptahla The title of theCeetiMrig Official, as tetephotto ttmher, and cut ti-n,ail tddtesn also cuss be podded.

Otre the completed Erripi Rrgiaio’triion Fomt ‘a eeeeistd nod prores’ed, the HtPDH asnigo. a ottique,coeildrrliat Data Roth tdeattitieatiett is°ember (Data Boric ID erDBtD) ned neodo no EtseiuyRrgiaveuriottVceijieatdn,tdectmietototheeod~ Th’adecnanettcontaiosthcciothncottftdrndalDtatonod pattanoced,as sit] us toe ilidamoatisu — tsas protided to the HtPOB oa the Ettritv Regdsoreeaie nF’orm. lheCanffhsogOtittdal shotdd ‘nod the dectooatt caneflalty o4 if the doromeastcontnitt,aoyetnots,foltatothesaoucoinsn pooddod eat doe t]octeoeoc for ceeootieg the ‘racetanir itol’ceteatiet.

HtPDBreapotseseoroestndqseetesueercseveds-iathetttpDn’stnteoatedQ~0wdgetgSeedee (IQRS). EanoitiesaldAeeuttsrnnatlepoetatheNpDB.HtteoBwebnitetoeeuies.elbeirm~,,~dqtetvtespomes. Respoossesthttareaotdeaned or printed soithit 30 days ofhrieg ptsced lot the Ft,IPDH~

Februan 2000 ta_S

NPi]B’tllPnB WEIOSITE, ~flVbV.Ntt0tt~I4tr0B.COyt It. ELIGtBLE ENItTIES

toonelirutbe a Dab book ttte.eirornttau Nuanloor

tfstterethy’u DBII3 is cuurenoty inaction ond yvureethy deteoosshtoa that ‘a nheotdbeaaise,theCeaifyiit0Dfrciat nhctutd ehta’et ott Eta!t,o’Reyioorna(aoo I’>’ ore fees iota oarwebiste to reqaeso dint the DBID hereaceasBed. The reason — renethotan moB he prodded on the completed form “has it in retoonted tothe httt°OB fen~noceostag.

Cedanine ttutitv ttg’tenotlteat

tfyoaoetntiw’seaeoe. addera, oaenen’amhsehy,erpaoizatiott,ye.ceetifyingofficb],oraatyotheei,nnor yost togiuosnlims ina’cossatieo changer yam eethys Cetnifyitg Otfie’ol should otcie an Eto”yRcg100ontett 0/pilots’ lone hon our uyhshr.

When the P011DB rrenisn ttpdoted entity iofermaiioa, alto updated ‘rnthoeahon is ponoeseed latin thetltPDB computer tystoes and aol 0oIio~o Rrgialo-eiisaot t”erdfirnoioe documetn, tetea’mg the elnaaieiouhmitte4 is raaiiod to the astiwt Cestlythtg arnold. The Ceotily’tsr Otieial doetd read the deconernruarfaly and, if tie duoumeso consthtc oar ettot~ fellow the iisnetieas provided en the otocnrnrtt forcanreunine the lasacotasne ‘ofonnadot

Loid Yo~ Doom Tooth tdentitientino Nttttmr’

tt’yonar data heonme cerntpoed eryoa isnoti to dracta_ale your cueretto OHIO atd idiotIc a 500’one. cattttte NPDD-I-II000 ttetp Litre fcrasslstnaee.

indIviduals Wito May Report to and/or Qitcey on BehalfofEotibtes

Quaies and repeoss soy he stabostitted to5 and tms7tomes nay he rossieved thorn. thetttltOn on behalfofregistered estitn by Ataitnefeed Sotnonieert or AttPo,tozed Ageota These isdeddenls are defined asfollas’s:

Aoatbottia’td Sabtonitler

pat Atehoriard Ssthmherr is the ‘odividoat ,elecled and n’oposonoj lara rogiocred stab> to cetti~ theteeithtoqefiafootoation repected tam rrqsested hon alto HIPOS via the lOBS. ttmno rosen, theAtdtetized Suhroiagr in at eontptosee of the uremia os statrnieiog the retwus or qntery’ (ouch as anAdmioistonar, Medical StatTsceviceoolticer, ertoiskMaetager). As ro~en>’dltacnetohas-rttoldpIeA0600tiacdSaheduetsc Eoressaatttltaaanoitvenaydenbeasaoeopmdeabettshvwaa]ooith’otheore~tnoiosto he the e\sdtoeired Suhtssioer foe tepttlv~ and another iodioa’docd a he the Atahoetzatd Submitter forqneeyto~ The Authorbad Suhnniner is oflee the lao]istdaal dedotsated bythe erganinotoa to oclntnh and

NPDB-tIlPI)iO WEBStTEe kVWOV.NPDB.Iti0011.CO,tiI B, ELtUHILE ENTITIES

Entity Recerniflention

The H]000 reagdtes pedadio eeeerdfieatieo of etiiibilire hr mOtes. The 0080011 s’ilt — the ootrettregiomintion tetfototaniet to each mire mtoy~ Die entoys Ceeifste DIOeiol dicsoldresieovtho hsfennatdan

us etnsuee that lilt sonnet, indicate the applicable oeoifioetiat stotement, sigtt tte doeumeon, mod return itto the litP]30.

Palo ]Oonk IdentificatIon Nnimlaers

Eaelteetiovthatoepiotetsnss’oot]tetljoonisaooiesedoaoiqaeoBtoaodpaassserd DntOsaeeusedlay0000DtotoldfrregioeerdeothiesacodAeanos,aodtmnobcproviddooso] repattsqaeoies,aodcertenpottdeneeschoitoedtotteutt’I)Io.

Vrntr eattity’s 08115 iso hitS into the ttt000 computer sytoenn tad dssirld he andlagoceded a preseathadve0000td’coelmiee,ADHtDioresoolejootyopthsegvoAgoottosthiaisa,ssigemj tathernenttoat~onareothy’aDSl]3 iseootspeoeoisettfollos thetnaouadotato “DaettningaDatatoath detthficaeinndoom he?’ scab, below.

The osaigmosaiiel’o ‘ntis isansta reponseacatoo by 1005 that so entity meotodsaotirilduirccttoetiad,rparticipation hotho HIPtSH,asspeeificd is Srotieo tt2tt. It ‘a esseit eoitity’o res-peeaibititv todrternt’mewinettoer htssecta theetieihilhvctitgojao,oJ tocettifrthatetigibitity tothetttpDfl.

DillOn aneautireedmtytoentitesdutceotifyotte’relieihiliayoa dtgHtPotiordto,oaatnonized Ageolsositoace 00 ttrltotf of rneistercsl raeitiesc 08105 are lane nnnfgoed fan A oliooriaean Subnathic’es or ocheritorOil’idooirannoeiareottejeit a repoeoitog or pnoenyfog entity.

Deaoijyao bet Boo, Hank tdranitiooniett 00

If at et, tit ctretityedhnipddonr(gibihtyto fusticipato ‘ode IBPDB, ytu moss osetift the HtItOB todeaetirnsteysooronlo. Thefltaitj’Regtorrooioao Lieokrrefon, ssttirhooo be oruiesed freonotte tenoR.tttt°Dtosstboboe,mtost beconspteted iaotdorto’reqneodeoctisatiro. Theeeasoo fard.aooissutiooooosoboprotidedoo the eontpteoed fame ssheo it it renumod to tie HIPDB fa’ lonovess’eoe.

.60 etigibte eooitv, by ceetnpletitog an Entity toegiseoutier tifolate loon, tony reqoest at o~’ tlaoe that itsoutnent Ditto he draetisotri and nurse OSlO oroigeed. For ittslaece, ifyoo helms e that ‘-osareotsy’sDtatohilshorneenqamoised’uotnyosovorifyureothemegrnssithspa,thaentiw Theteasraoforremqaeotog anew 0500 onion he pe’ooided on the ootepleOed form “hen it io reramed to the I DODD feeprecessing.

Febrtaoy200t B_I

NP0D~tItl°Eao WEBSITEt WWW.NI5OB,HIPt]BCD’hI tO. EUGIBLE Fxrrtrs

trairse cepeonaod.br qttetyeosponnesfeom thetttPoitltinsoesnr.othereenpossetcolypetsernel may hedesigeatoot,nsdesfrtd.

Registered neotlies mat’ eleoe to have oaaside repsoomizatinoa teptoon to neofar qneey the 110DB ott theebehalf, .4o etgotizndondoleepaalstaantiicrqsedestheHtlal350000 eonthv’slttettalfinrefeosodloostheAotth&teot Ageot totoost ennen, no Aothatieed Agent loon ieis’pcodeet cotlaataner to dtr entity Ce..National Cosn,ril ofgtate Braria ofldtosior, Fedeontion of Chioosgnnetic t.icettn’asg Bareda, CcedeoniotitgVeoitleaiot Oogoo’anoiee) aced fw ecolontred crem]entialhog nodlor peotfes,’oonnt roetsigioL

Erthia toted etsraor that conaioo goidelireo nan fotooned whets designating so Aodoedsad Aensoto egnoetotoiOorqowayoto dodrhetoalf, Eaoddes sltndd eoOahtish nonsitimss aoreeoeo,t ssi’th tite Agent coefeneing thefottassiser

- The Ageoimtrt hr authorized to randton hett’ness in the Rate.

The Ageot’u forilitiesmosthe neoeeelo otstte &conttdeotialitvefllitton oospnnnsm.

- The acreaneet soith & Authostioted Ageon tint enpl’nhty peeloito & Aeert font ovine ‘otfoteodrariotatnenl freon the tl]PDB for any potopaoertherthatt &t for othich log disclosure o,sts mndr. Forenausple. son dilfeeto loealth plans dniosate the name Aothotized Aeeott to query the H11°DB 0° theirbehalf. Bothhra]dtpbnsss’ohtoteqaaoiedlaaoutonest&otoeproadtpaner TheAotheoizoiAgenntstoma quay the mOon nrparntrly on belsalf efeach health plot. The tespoesetos 0010DB niotetynatonmited ferette health pbe entree Is, shaonl vaith ooeo°oer health plan.

- The eeaity sloonld etoatte thad the Aonlamaoi,ed Agent ltaan rof)? ot’ttoc mo’st oeceost Guidebook (olilelt‘oooludes tie torgnlaaieosard the civil noatsy penalty regntntoas of& Office of tnspearr ejaseoo].HIOS, ot IS CFR Pan 003) tad should nuke the Aostoooi,ed Agent asssoe ot’dte satet’e,na that coohe Intern agsoiest the Autonoigaid Agent if btferrsation is rrqoeated. too], or dtmclonoi ‘on sioloOios ofHtPotoptovtt’mnr

Dvot..onatiee 4otheet’ud Armooto

Befate ran Aithoorized Agent nit, ace et &-hdf nfun neity. die cati’ muss damignuto the Ageot in httmtoctso’rJml]ugH]PDflot imhoh,lf, Rrioerrdeonttieadosssontto&-siensoetnArehnoiaedAreolshrold&naioanaturftar!retddgeoofleaiptoi,ooto fete ‘otto die NPDB’HIPDB ssthsioe. The mtily must complete Orelena, prodding & Auttcoizmd Agenfn tame, Otto Ortaooncn, tddtesn, — telephone nomheG itid theenthys tiespotee condor and fee poytnmo peefeerecew nod oe060 it to the HtPDB,

Febrtoan’ sttt B’S Fobnnan’ SOOt Be

NPDhi’Hll’OB WERSITE; ~VWW,NPOB.HI2OB.COM B, ELIGIBLE ENTITIES

Awitceneed Agents must ho coetaimed with the H11500 befcae they ems be designated im cogron andreqien-on hehalfordigibte enibiw lithe Agem a not regiseeced noith the HIPOB, the A ate mum otsoinan Aeoln,rized Agent Regisirason fame the NEOB-HIPOB snehnina. Once the e’igeni is regioered. aDBIDaod an den-one moitbon pe,nsucscd osill be nisicated to emnAnesa. sad die enllltcandminnamthaiAgent in repeal and/or qoay on is helsali

IIIPOS resitonven to teponnanod queriesnubininml by an Andineized Aeninnni [I be recited to etnherdreetjgl,le attic or be ,Autheriard Agent, as indicated by the mutt an the Aitrlaatheaf Agent Oraigootian[cent. Ifetiremiivndsltesbarrthneieupsnsesfromthe IQBS risks anna elecannin niaithmç (eegothvcam hare access in die Interns (i.e.. an Internel Sen-icc Plorider) nail an linens;’ bnysnsee (eitherMieeotofl ltntennet Explorer or Netneapt Conannnicatan Vensino 4.0 omens en).

M Aedarnired Agent doaold Imneonly ale DimO, even thoagis anon than nit deity nay designate theAaeniloqoeiythe tItyDa, llmiAneltorired Ageni lierbeen issnigdmattlloanne OBIO.theAsakccieenlAgate diaald ebiabi on Ages’: Rcgtnirotton UpScale [atm floss oar vvebstte, holinathng which DOTE) itintends ha toe and to request thai any other OUTDo be deactivaled.

Ann changes Ia an Anthoitnad Aeent desicrotitec nude as a change to engonior rnutisg em imnniraf us ofan Antho seed Areefn aothunieghai in queer on tse cnbifn hdmlC mini be nahaninnil ho the catty. Ifchanges man Actltonized Ageua deskatatirni me ieqnhe~ the emits shonhl abeam en Aethsrieael AgentDesignaoaai (4adeiae [aim 0cm the NPDB-i IJPOB entitle.

Qncslionn and .Aiaawern

I. linen del tint if na niganleation is an eligible entiTy?To be eligible a reedeipaae in the HTPDB. an mgnnizatiau mint meet the defoitian nraOavenmoentagcncyoralimtsliplaeyasdelaieclnindersesiien tl2EEoithe&cialSeenri~’Ael. See1613, Dgfinhiain, ofdee dm015 regniboans.

2. Can nbc HIPOB ccrnifynmnerifa- IliaC ny niganln.aiisn in eligihlerareporn or qnere?Each mfty mimi dclaxniae ha ones etie_ibiltiy no participate in the HIPDB. hit HIPOB asgstaticnndescribe die urlinia far etigfb)ity. Other mnfcinaanieaial enatetials deutcacil to a.sat )oa msdeteinniningatarorponirsthn’sgli gibiliiy Gate be fotonion the NPDII’FtnPDB mebnbee.

3. Ones niyrnlity hive nn nniify The IHPDBn,-h caere haven new Cemnirying Official?Yen. The eliaahie atdtr given tine Cotrying Oflicial amlnoeilv ha caulk the Tegilbenany of regisaanioniafstataion provided in the HIPOS. The penvsan mdiorbeil by the entiTy no act as the CatifyingOiuieiatnnnacchaitgennaay Linen’ thedivadtan of the entity. Hoo-evet, theHIPIhE nnahmn crucial

Febnincy 2000 0-7

NPDB.llIieOIn WEBSITEe WWW.NPDB.TniPOB.COM C, SUBJECTS

Ovorvigw

The HIPDB collects and mahntainu b*taaattan eevptdhnr Onal tdc-eive aelicues taken anahnn health ‘annepatnethirnees, pcoeidens, and nnpplieis. l4lPOB iniasnaaairn is hitended to be noel no help combat healthcare fnnd and abese, and in ‘nnnpcece ihe qaalhvnfpatioilerae. Enaanplenofthen)penofgctirmtnnntinjiiIfl5DB infamtalbethnald beiacd incoinhiaaliaawiihiefecntotianfrainndenmaeignm haetlde,hniareeollinked to; allttiatien,entifteatinn, cresletsaaling, cn’iasanilsng. lttnhsa, and ticensarn

Definilloen

Since therein eanrskloenhle ostolap is the coin, of pasetitianea pnos-idces, and napptimn (e.g.. a stalledcaning faeintc ban betiadonal poevuda, his nIna can he a nnfplim of hesith core items and ee~a5jsniecr),tine temn’~eaeltlcnm[peanjder,”andonpplief nmnrittodencntitedisth,ckntmaajlyevylnnivecaneganen, enraee the examples peovidead intended tube rsliansf cc.

Lmrenced tiaudi Can PexIhisinte Licenned Pnaeiiskeier. mel Pnsdhiinsncr

An mdkadnal “ins is licosted or othenvoine aathorieed by the Slate no peocide beanie cane ten-ices; no toyiotdicidnzl silna. ncithem aodsnxin’, holds dometf cc ltatolfcoa to be so Iicrntcd em aatino,oeed,

‘AtnocidernfveevinostsderatedioSeciinii tt6u(o)ofthnSnnia]SecneicyAet- sttyhe.~cnrendnythanpnvcides heelth care tentcenand [aBeam a fomnal peer moles; pecceos

the the pniqcsse of fuatheeing qaa]tre health cane thmladiig an 111.10, EPO, ne nicety meadieadpraclicel.

‘Ann nther iseahb care mills that, diiecdv Or thrceaeh contract% piovides heath care nendoes.

A paoviderofinodicatcrotherhealthcaseaern’ioesasdesorihadiniseenion 1061(n)nfthesaei,nisecnsci0--Jet; omany ‘odividaal or mains nIna fnenidirn, nnhcthemdieecnlv orindieecth’, er provides aeema ha. healthcam amet pptwiteoin,crxioilaevrecvicen(rehinim&hnieoo litnitodno.darnblemedicaieqntpneinnmpphms; nnwafaenarcro of health care items; plnaenacetsieal nappliors — mannfacnnaen; batldi metedscniccs mdi as medical, daaial and patient neoonlg health — suppliers; and hilling and narsponatianrenicesnrgSmi% Theearn edna inehsdeunep’ iothoithaatnrenthyondesconhscctcp000ideradenuppties,bans, or ateillno antigen; health plans as defnnnl in 45 CFR 613 (ntclading eniptoyrts thai me self.~mad nentsnnance ‘mtennnodiadenl.

NPDB-TTJPOB WEBSITF,t WCVW,NPDIS-BWOB.COM B. ETJGmLE ENTITiES

ohlse Isffddnarnd trana of the belioithel anaigned aathe CauiMeg Oticiai nenlshn,kiberooifiedsvlmn change, c’ccot.

4. Cnenniyn iganiaitinn qnen, the HEPOB i Ewe arenni maneialed mepnnrenII latE?

No. The senate delirms qntors and repotteos as tie sane orgaa,iatiana.

5. If nest relies; qneeinn bin JIIPOB, in aisn meqnbe carepnmn? Conversely, [my cadettepnris in ilie lelPOm, is in niinmnlicaltn- eligible in qnnn3’?Yes. Eattitien that cegron no 1111,01) ace antantadnutty eligible to qseey.

6. tnneyeniity reqnimed tn qneay the lulPiats?No. Sncticsi 112(1 deen earn tel manalaiaay qaa~ing eeqnfreneenin foe any entby.

7. Can my enlily ‘ins-c morn than nan 0010?tfyoa have mnlfiplc depaffineots ar pecple nnlto handle HIPDS qn’eryng mtdor repenbie, ~to irsaaSreg’onencadndtpntncennrrernonsegozsnelyandmcerivraoepaeateDolofereaclime. Ilasonever,6 should itt ottod hat the dilt’eeettn DOIDe em-not help each other G.e., ate depatnoxenn cmesesndownload a mnpomue Irene a query eedoncnl by another depamneni toOth a dtifeeeei 001Db Also.syceint emnmaohniaien to be suer than the sane mpoct mqaoy knot nnhmietd Edge,

Ii. Which ban eefnrcrnicinn agencies Mill have accent lathe Hiram?The feiscothig nec msattptcn oflans ettloreattect agencies than am eligible iorecexn the IIIPOB; lieOffice of Inopecier C’ inal in the Depamttent offleatth and l-lumai Sen-ices, the Dogannnsonnt of.Ieasetce, the l°cdeanl Banns of Investigation, the Slate Medicaid Fmrad Ccntmt Units, the StateAsomays Oeeeial, the Dtsmini Anomcass, and the State hoc enfotveinart agencies that ale hwolceolin heahti tale isnesaipatiens. In idditiec, other Indent Inspectors’ Oceenal mid nther Federal tacteeiticrccnee,rt agencies tIal me havolnedha health cute innusuipation ate eligible name,. the HIPOB.

9. Are Innnpilatn eligible in access ilie HIPDO?Sneiion II ZiEdexs nanattew hospitalo Is queer Cr mpoieno the BluE)0 italesn the ho.rpinil meets liedefinoian cia timId, planer Fcdeial ar State anmo.

Feliroan 1000 B’S

NPDIi’ltIPDB Y,’EBSiTEt 5i’t,fl~NPD0’IiIPDfl,COM C. SItBIECI’S

EsamnhoaefPn,onflmens (tnrltolr,bgtaaaaoiuiatieedno);

Chlmt,tsaioe Fhg,Ici.eAnniniaeiPicoiwina ttsioictast. Attnpaltto

Csian,riot’ Phn,ioinnlmieesni, Os,eopitnlnCane en t ry S in sue Iteatisi’ssresais,al C,txe,elrc Pnli.ielese-eise pm,ldaeFeafeenia,catcssenetoc Atoslsct PadhnoiniPecceoaiasoi Ca’aneolc’c. [aseiit dieaeiaia Podiesie Aoi,nani‘en In e e is e a

rn,nnnioniai_ CiheiynlDotiini iernlie Pen idesOsestma Onhabmttietha, innepienteep, end RealantineseenjeeDenial Be,tdeot n’enflh,ctacecntAneintast .‘eolesssatianhansyisttasniol tl’jtnniat 5lnnnaoa ThmnpltcFnnstoni en 000spatlotalmenpiit

OooapotbesxtThneapcu,e;neestilleiinineentedeteotn, ‘hi-sian ThcaspineDinuian t’tsoviaatTtaraya_n,sietantiseeitiooett Rahahlisetien Thenphet

nnpimnsev TheeatsiO -EmtegennythlnulrdTnhntsiaelcsiT~ Enctsieatseyeaseeap,-TenoncaeanSail. iasiopan]. Cedh,avdiral Care ennaatwnet.errlcnt,is,mnoeintec,vlr.t’eecatha

speech, Lnsgsngc, end llneiagBa,sienNacao5Adannaeei Fanteimitineen FroldneRenintnsadeP,sfenn;,soaiittsne nndtnna,ni,tNsneantinrthetini Otsnoi.h.naocaiei’ashstoahni“teen MidasirnNuns P,aoit;nna TeshnntaØtlLimu,edeonnde,tcevamiiaeat,isa,s. hledioaiTisheaiisainl

Caiainshmioni,ltitenealleainninlleahhaide Noatmahidicnex,siccoconinteaten AsIa loclmoionnnvn,spa rsdseii,gistItonniunslthAilaltlnaeothel na,tisinnieTeeaesslaaini

canandv’i,i en ~nexin Feansane Oilier ilenhh Caeel’etcililaneeOoataaini AmpoueseintOmtioian svthlanieTiaasoDpietnesrci ilsessepotta

t-tedieai Aeaiitaatrb,emaog’oe,sian Pnncialen i.iidvaira, ny INne-nanasFhaemaclae Natnmpaiht’hanoimini, Nsainae Ontssnins,Pr,nitimmonlttseePhae,ssnp Areintasi eoetanhocint

Ptyehiatda TasheinlissPh as Ic Ia aAltspsihio l’icnhiies MDIAlispauhia PbjsalnanlnennteoaidieiDempathteBasniolos1aaO)Octeapathis Fhnp,inian lusanecnidnsi

Fcbnian 20T0 C-IFcbrnan 2000 C-i

NPtIB-fflPOB WEBSHT, WWW.NPDB.HIPDB.COM C. SUBJECTS

rs~eisetoea.rr.,a.eoc,iieno&.hstamtlit.Aet:

,o,’r-’e~.rr

tooth (4ar raotoer Admioioleuter OIlier tio.tth roes-mauled recodesMail C laaitiiy Adn;eiaseerIlp]Ie:lAdmi:,iulestue titohkeoprtg-Tsomrneedrthniniooeee nasttteou .ldio~sr

aasisrs, flamehealth Io,uaee Pehinoppller ~~we~e OCtanetruere Ageol Retenreher CiteSeaTlenoeoteker Selnspcosee.

—thonpilal Coil

Amholoae, Sin pau.ensCenpat,r rnyeh:.eoier,i(antiobjlrtauion Ccii

GpnrP,unlinrCU,o1sncjo Grosreoetiee tahanehn,yflto LahneneayDeOitaprlnuaOoolelndieniOrcop?tosiJee Yonhtt F.rlIlI.tnkilled Norton PenililyMnetat HooIth~nntie:eAboneOsuapPr.~an Rneannhcrnlon:PudTilyOptician. op ti aeft To tlinn p-Pined soPtosIosTOaaopathiaat Thriopy C. Peiceine OIlier 11.0th C.eerseielyPd:.Oeeveee:ien AOslhDsyCanoFoeilitp

Aeeboiaeooy Sociad PesoIinoIlh Cots Seppheealua..e.ooc.n .blshctttoey 0 tooterIhcileeieai Pnseanls Nhao:,faetcoe foal slots Stool Boaeo InoitlicBlood took FlatoCn,trryrdncitiu Qolifod NorthObletserqaipoocisrpptier C:CtmceoinjlemtOtCno,nFiocaCitisolytoateeennt nero lotasnrdhioe Cner Ineilty F nslmioliyNo inch hCooslofsoane,nico Rnludnd’tobooeorctatsoOts..i Fmosnnee,n, Otpoimdo, tTomoenpinp Session P.nsioafresco,, fqoipenotncfldie, tihoot,t hletoith ConnvConer.ooii~ Maccot lirniOsrhoaPom,aoosoeoo Menn[,snaoos Ootrnitnnt Rnhabitiiotio, FooiTihc.tnc1mhosninoPens-tile X’ooy Soppliac Oaepoiona Itohohilltethis FosithyI°czohaa,tg lecteo Rodioitpyi too Voile,

Rnddai001itnettohFocitlirT lhcoeaucoUselib Inso,o,oo Conpoap Real tiraili CUte

Hoiteoh.h.ttrnoy:Oet.dnath., MoodcOogonbnhio,Ilmldoleainteecnio000nu

blasplronlc,pko Car, cooed., Foofosea Fidenoeaoinatji.oPresider Speotord 0 trait,

hhn,pIiol Rnhravtontn,oot innoOt Pacteta FloeOtortoeoto ComllecpttolFsanhhiinic I tenet alRrt,ehiliadoo ‘‘r~’~Ps-Iron lioeptiel

Frhnaan 1000 C.3

NPDB-HIPOB WEBSITE, \flVWNPOIS-HIPOB.C0tiI C SUBJECtS

For ftethcr detello mcandhin the F1IFDB dipueptcesv’clllrsotheOinpoorcsncettocofrhhiGoi!debnek

Questions and Antwen

1. Hocndnlcorroetnuvndobneoirihhnsvr,pcgi,nrrpura?

Because neitherihe IBPOB norasohjcct ole nston my mbcif~ hfoemiiors ceseatred in arepon.Polo moo eenauc&oeprenmgnfisv(dcnafied ho dtrNostlJrooinot nfo Rejxoro recite DaeuBiolekfridecconent) and request bat it cotncotdio address Cli doe report lIke reponhigcoltiv deer oat hecor,tnw ecqusoal sconce! the maccurer oddrro~ yes may dispose the repott Refer us the Distuerscation rIthis Gttkkbook for talons iuloenauirn about the HIPUB diqilote process.

2. Can a health pI.anra Stoic Licennt.tg Born! reqotrr thai I gisn hem the millie ortnssseife

limrrwoneasuoleceveoatf1aeoyis)teestodoesohas,jauwoat Voetrosticreuhitycdaldnl{ttgU sad innmipp erganionilnas my require a copy clyatur to!f.querg espouse helote ~OO

potticipuro hi thoir piegeant My anaugocest helssoat yoo sod see or their cop, is‘duct,, HHS&’esnuu marble sac)’ oauaauremesslc

3, The reporter tee tteoioityoar reqami to careen the report. The recoalatitite sa~ tint on1y horeporter eat make chanter to hr report 5~lat ross ihnuohjnet do?

Yea may add a 2000mtts,ocier utatemeB to the oapoel. condo0 s-halt s-st hetiror occtetcd. attlO, ifyen belies, the mepreetedeesnot ecetthesppropdatrctjtedu tocoetetihouitarepoi erilthnearalaaoaliooaeocinuiothe,epoti,yesanas ithieeadtlpoteelthenspottRefrrtttheOiupuuessa~ooolthiu Gattiolosb lee mote tolemtathio abort be HtPOB dttpiote ptoco.’us.

NPDB’IIIPBB WEBSITEt WWW.NPOB.HIPDB.COM C. SUBJECTS

Practitioner, Provider, and Supplier Solf’Queries

Pnctiiloteri,presidnn,mtdmlpttertmssrqosensdmHtpoflregatdirtgthooowlun.ioctl.qeon)omoythee.Atxocddeonrpeoidce.erttoppsermsa hiidatoaoetf-qaserv bvconcp4ritt.ncsadteeataisgthnoetf.quay Ionic found on the NPDB’tIIPDB tsekiic to the fottoosieg address;

NlbDB~tttpOBP.O. Ba, tot)?Ocaadulv, VA lot St

Addiliomt irdreauotictt on the teIf-quems proctor ran he obtained etc tea NPDB-HtPOB trobuite.

A peaedhireee. provider, ortnipptier “ho submits a selfiqoeey to the HtPUB inSt ttcelsrio as-spsioa,a celiaa mtitrsthc that no Iticossadon eniet, hi the IOPUB. era eopv of alt repee hifem,otire otdtoniacdhyettetbPo repealing enthtes about the prscthioeer. presider. or sopplia

Fees are chargad for alt setf~qeetiea to doe HIPOB. and tttust lie paid hy credit ‘nod. Ft,rher debit,minitbcpustnornofsetlnctvfeesseefoottdecrdooocPDa.HJFOB isebsite.

Practitioncfn Provider, or Supplier Teiformotio’, in the HIPUB

Tie HlttOB is coesiaiaed to tnainsnhdng oceanic i,tntanttatian and encoring that tteatth tort poactcicmen,leoridetvmoisapatinsamrinftmscds.ltentthtoeacdots atereponett WhectbeHtFbBreceis-cearepot~ the htfetcnadet bpeoceaeed hy dte 11150!) eoepater lystron esaaethjan othesined tly the tepotihagunits, Ret’oOite retina are eenpaoaihte fortho aeemacy of dte tefenonaihiu thor report to the FUPOrt

WbtentheHtfoflprooirssuareponaRtpara tbe0/iroatottoon.octaisseoitotheatpeoitgmtitv,asda .VnetjSnotmott ohs inc-post let Ode D.ooa Btotk(s) is sent to the tuhject. The ptactitioneo, presider. ortsp1othestlta te the nhjecl efdteetpntt slmostd eesic’a the report Iccacceracs, htctadhtc saehutfeenaoooas catretit nddteat. tetepheemnumhem. amt ptaen ofeatptosnntent Sahjeris mny not submit eltangeotoreptras. lt’snyhalaortadoiohoarrpstl hilracctaste,dwsubjercmo.sTcoetaotheiepcrdogaaisptoreqoeelthttitttoocectcahineo*enpoet TheHlPoBlepeohthitedbytawfrttnmed*flertnahtoatns.hioitedit! tepolia.

tIthe oepottloe mthy rePress to correct the .doltorsc .lcntan Ro’poro or the ,Oadgoteot Or CoredntlonRayon, the subject ef the repro? mao:

eAddnttstenieol to the repelshutlootre disptneefdte eepott.Add a itosentees sad initiate a dispuer.

Fehruaes 2000 C-4

NPDB-H1P0B SVEBSft’E; WWW.NPDI!-HIPDB.CO’ns 0. QUERiES

OsToniew

ThelilPUB isareooatcetaasoislloeatdtptatssaral FetkttteedStotooevtnunontagmcieslocoutdttc!bsrenlerreotum ittoessigedoro ted restates tithe qastttcstireu of hse.tth em goetitiootetn. prasideas, rodsuptutius- mc pdrmn eerIe of the IBSOB ace tohetp prercat fnsodsndabueeh,diettadenattoeodtheeoeopetout ted to tonprore Ote quail!) of patieti ease. It edditien, quedns may s-es IIIPOB itd’mmadms hi

dog ssseepmingatithitinavceifcadoaro,oer,cohos- oodertiathtg..ooptesinotkotdticotut,eofpeevthhimnru. provider,, and supptntu.

liv HtpDB rettecn ared dksoe,hsoles to eti~bte qsedets hlfomustioe cc;

- Health caee-rctated eicit jelgaaeeos talons it Polecat or State roan.

- I eatS care-related eitmtesl cottcictimls later hi ‘entreat cc StaTe cells-

lii ear ens

Fedetal or Cute lcotnaeg cad ceeitealtots anions, itactadice resooodecss rmpoitnands: censlees:pooleetioes; sonpendotto red ely otter less of liceaec, or The deli! to apply for or nteew u tiwue.snhotha by ratteton niorerdue. llen-eetw500hilily. or othenctan.

Euclesionnfeem patticipoden hi Federal and Stole Itenlth ear poogoma

-Ms other oahjadtculnd ucdoos or dcrtatom defined by eceotailon (see the Reports thapcer of thtuGe!dobonk).

FUPOB Itinneatios iS available. spot reqoeth Ia;

- Federal utd State Goensononi eonccies

ItealdI plans.

- Iteolthcooepmc0dennaptovidots,snalnupptierean~neteoghifooanrlbacsnrerctnisgtheeosetsrs(olf.

- Pets-tn or otgmuizioloos roqtaenting hifoehoodon hi a forts ssllrdh dunes root pencil the Wentificadre ofcc) pusoticodor podees or healda case piaceidnanr, provider, or topphier.

The ‘milled sores, proC tons ofdm S.ctitn I l2lE do not oiiow the dinctosasre tIHIlOOB iefeomeolactnthe erred petite.

Fcbnian’s’ 2000 C-SFehnninry ltOO 0-I

NPDB-lIIp010 WEBSI’PE: WWW.NPDO-RIPOB,CONI 0- QUERIES

The 0IlPmBs~sslrmwiII nan alosnenhilin naoobmil qoedniahicli dnnoninelodeinformotion inall mandatory fields. 15w I4IPOO soagents dm0 etches include, as past of tier apçlicanian panceoc,iafam,alion needed to ceeipmeae mandatniy (alas for I-lINuS queries.

Types of Qlneriera

Frdcnnbnnd Stale GQscnuntLcnir~rqmcJca

Caannioljteniceaothvnidcc, govctsnnancsl inseudranenc, and peonocnacss may qor’, die HIODIS no (otherinsestiponionoos hmlih cam poaclilicocns. pnosidea and oopplicos. Fcdennl and Slate peasosolaus (e.g.,indeed harem of lovcsniganicnc, US. avntomrv) mae also our HIN)B infcnosfima in noSaing dccisilvmloaccept pica aeerreasrms or in leaking scntcrdng reconvacodatinan to the total.

Other raveununscotal ornaciacqoless osoy qcer5 due HIPOB ssith nenpecc a undmtiarnnw licemhnn cccealifucanho of hea~ tate puncuithoserts psnaldece med stg~slicow Scone components in this poopathnmioee cc povirpaymenl for smith cane items cc scrvicec, white echoes audit esnohouc, and resirwparasol epco(sos to redone clThcdvnnosn and etiscinecy. Thonc nnpaalosdcm ersnurosblr the licensingand canioratios livccdms may cisnooc no piany the database Is voutiunun cv coiled mikosnadon daring theuaicscotmitial ornvoessol apptiraninsua Sitscilady, ether PcdmalavSuatcagruscv incas g.g. Sonic Medicalcard, Food cod Ocog Adotiaiosnciou) may choose ta qorn — HIPPO no dcornissinc a puacoidancic,providri°s.craopsplie?neligibilitv iorpauoicipaiiaa, ortovocour thatsulijccnshavr laacompascdprapeabn,

ilesnnh b.c

llealthpbos n,avhavra sonicivofreaccos faqocmgthclOPOO.pmtykouvbiiasiocuedenSalisgorstooacliogscithpcacsilioocis5pros-idrmoasduopptirn. Healthploosmayqtcnycnnopcciocoobjccmssluohasss o1gsicd or arc hciog caoshdc nd foea halos ssdth dog plaa

health plans alas may cpicrv duo BONuS us doted aud isvedicatc pooestial fuandolmi tad ahnasisaactisiiyrrbucduo dog passoguni or delis-cuy of benign once services T~picall~, health plan tunis develop cases farp500enlauioo Ia Gossosonoin ins esuigioloss oral pnnsccunons ‘sIrs. ‘monet. sake slur infomnaiiosu and mostensued cuiminalcisil, ovcbuiunimrsi±ocacnksoo. HIPOD isfamoanhosisoyalsohonnoibythnhealthpiao’strout eeganizsuiao no pousion civil aguicon auaiss’n a specific prceuidrogr, Incoslacru 00 uopplies.

Pracoiuinnee-c Preusidnic end Senuntinic

Poctitiosrrw providers, and oopptiers may rrqacst isleannadcn ahoau themselves (oclf-qocu,) toot theHINtS at may simm former pciposm

Frbraan’ 2000 0.2

NPOIi4IIPOB WEBStTEn WSV’oVNPDhi.sHPDBCONI 0. QUERIES

Query Processing

bThm the HIPPO neeghomna poped5 cmsplesed qony, due ialoirrnation is catered isle lIes 0111000ecospaicr system. The compoier 5)50cm prefoms a validation process dim snatches sniseco (Empa helene avidee or cspplicr) idaanifsino nailan minnired kn die q ssinh intktts~theospces-iesaslyecparied uothe WP00 [ofomsalion crooned ahouc a specilo goactilianer isretea.scd to anelicible qaccieron~v tithe iJeos~-ing uttsnsadon provided hi the qons maIden the lunfosanraim marepoot

Fanth queuy processed by the 010011 composer s~sicsn is asalgusrd a Osiulae Occouratoc Cosnoal Nonher(UCN). This Ooucttunonn Cmlscl Nonnhsar is — hy bc HIPDS io locate the query within dir composersweat line DCN is pssoniomtly disptsyed is a qsoy tospcooa lEa qoenliass mines coocoiib5 0

psanicotir ip’av, ha cal~nuosn mthneors One DOt is any musnsspmndcace ice usual opoes.

Each geld in o qoc’,’ (such as Naain, ~Vcok Addicts. inst License Nscnbrr) is hunted ma contain umberof cliauscnero, isclodiina spares anod prairooaiicsmn. The IQRS ssilt nil allow duo oilily loose side dean theallosed nicnhrr oicluayaeicn. Tine RlPOBssill one olin inge any ioforoualion sobtoitned to a linen.

Eaclu nine aqoruy is soccossfallss prreesned by she HIPOS computer 5)8cm aqseuy resposnc is soaredisvdeeqseningeoooyeorcmricsedoocghthelQks. Pmntkioseapoos-idesaardsuppliossuhocndfqornssill cerise paper empoimes sent by f-inst Class 3.5. mail.

hTheut dssrc is usa inliurnoaokos isihe HIPOB ahoulosot~ecs practiuionrr, prosider,ersoppliceinlucqoeuiersslneeceivc hiacspamco&ydmcobjecihngisioanatiansidedisdueqowrva,idnnpsflus,niiaathauma hslbrmauias abosa the sobjrcu pracituicoes poovideun or applier is cesoaiccul in the hlll°DO. Queryisiansoatias is tel retained on schjecis fr ‘aliens no advcsse oclicos have been rcposied

NPD11-NIPOB WEBSITEu WinflV.Nl°0B-IOPOB,COM 0. QUERIES

So’bmitling a Qoely to Olte HIPOB

Elicihis esdde Pr ‘edo, unit quasHes osing the NI°DB’H]PDBs Ioucnnsecd Once> ion mmd RcpoutisgSrn’kr OQRS1. Fsyiiicn tray eshasil th’gtc-snauuc on nueli~srranne tIsslehi queries elogresiccby to theHIPDB via inadcmduocgbthclnlceoet ~blncnthriIn°DS pocmaesqccoy dauoahminedsisthclQtsS.the qon-s response is soled foe the qorryhag enuiis no remirve ituteogh Ott IQRS.

Es,oirooest NeesInsI TO done, r.loenoeenlmms

Elitism colilics thou ssith lo qocuv most have lonenoco access and mu lintcmrs hreirseus either >liercrohlonerrciEusplorervrssmnod.oI ScesicePock2 (one Inigbor) or Netscape Caneonuomicator Vemion 4.08 (orbunsen. Is sddhicon. a pissuia or stand-alone puocuam that can ‘rid film is Pousahie Dvc,oscoo [‘onset(PDF).ssrhacAdssbrdicrobalReadcrd.eisueqekr&Apnhocrisrrqnuircdlopnioorespaoncslnqoeuiesand rclnosls.

Oornioe missort, an Wohoeieasl Aaron

‘flnnFlIPDB’srcspooaetoaqservsohlsiadbynsAe*.onizcdAneainoa&huulfrfaneomjtvss)(bchasrd01550 oso cligihilitv slasdask (I) the engiiynuiiso bceanhlgd io umnsuioedue hufomnasico, aid (23 use Aneetonosn be oudiontysl Is toccisni lint intnsssni,n on hebaifrithat esnths.

Before an Aothvxincd brent scbraitcaqaesy en lielnalfofan coOls, the entRy anast iaudicsic no Ike 101000sshetheruheqceawrenpmsaircoabcrruomndcitheruanhrcsliuvceuethebgero;eecpaosamsyuuolbcretoasuodno both. Theenints ouost have the capability to receivrnlte rysponso throtigle lime IQESIf nbc response is cohn roomed back on lIme enoOiqr.

Audonizod a~emls most osdcrssaod thaI User cosInes nose a qoerv nesycuenc foro paitieolar pnaelilicncr,peosides orsspplieron behalf of mote than roe oadry. The 010DB reguilailnos spceiiu dm0 hufcomauissoreceived finite the HlI°Dl3 seal he osod solely ion the paupnse ire snluich in ssss presidrd. Thoeclore.miAoukamedbpe011lnsuqucdescoapaa-ticolarpoanninmauner.pmosidcr,orsopphicra,nlsrlualfafsnnrhealdu planray non nor One qoecs response far dial pnnucchtnncv prosideun or sapplicr iorsdhlrcccsi hassith plant.

MeligiblcqsoicndianbaadesieranednoAodsovkzed Aged inziropcooiuuedtrqoers thel lPomdieocity.Rcspsosestaqtcaieesohsoisad bs the enniryscill be reorumcd sa the en regasadless afroatiog deuigosondfor qaeaiel nobnsnilled by the aucemn

‘iso tmmoor H15°OB s5sssss,srui’

If muon have alienody revisvtred fec the 1010013 mud motes pests your paossitni. call the NP011-IIIPDO

rebecca,, 2t00 0.3

NPDB-mpoBwgInSflEt ‘nnvaIrommpom.co>s 0- QUERIES

~ic

Aqocms-corocpeacduiootcr,prosidenorsapplhmiscynssidcredasggre.osmeqorn-; squsrqonmorrulmosloe peannoioser, p-sunder, or snyplien is cotahicood a eraltiplc.osnte qocuv Each single-guise qocny inasnigsedaooiqorDCN. Amolliplr’eanurqucre, isassiuneda OaleloDCN,oodcacluracnicsoithitllieqar’,ha sunigood mu bnhnlotoi DCN.

dbllqooiessohusniredelecuomrutlysin thclQRsairrus’nnaallypnoccssedsvidiisfcotrnoshunlmon ci usanrilotHcsseverduuirr peelods efhigh caisson, the peccessiop nime sunny he anger

Ideslhc isa°onseosiaa frnuu tie 05l~011 will Tue cansidcteud dosing tine candasohatoc prsmcea hlosss,veun UseIOIPOB lass dees roe rcqoire qocniug esthetes Is receive qoeiy responses leans due Hp-DO bcfnvepmcccdinnssithluhtiuugcci&inwuaocecflireases. BecaascdirHuiooismeofsesvnslivsaooceolorthvmcdrrthalo testes, protest. cauitics may act on epplicalioss acvvediog Os their esushlished criteria lundinfaumatim ebninumnl tots rther

isshuo, flea ri Res on Os

lfvouisohissitiquonynothclhlPobsiathelQl{Sucudliaseoaureceivcdnisspsusess-iiluoiucsseoaucsJlthe NPDB-HiPOli Help Line to request a qoety sianoc.

Correcting Qncry Information

If the itfrosmsihoo sto sobnsshacd it a qoems- does lou sccorancty hdeaithfv the pratlilhansir. provider, ormfplkocnnslmtu>oo miendedmqorry,ycorqaciysusiiloonmaichll05011 reposlssokicicrd ,siilucgrvccckIonOf~iagmfcteadm. ToqsoythcHlliol odds duepaeidesdf~iogbnfresssadon pnthenuisect mhuoha ness, cousncdv ccmplcieol qoerv to the HIPPO,

Faihinfe 0° Query

Qocniog the HIPPO in optimal. Theur ace tr mandatory qnciyitng mqmoiumsscots planed on eligibleilolesiets,

Questions anti Answers

I. Whenlrogisuer dub bc [711DB, om I otlrmaoirallv registered to osr Obr IQRS?

Yes. Ycorovgaoahsanhons DRltaatodpossssouslfvvrthclQlsSaoginclicdud eothrf’uuinReginrcoioeo

llclptkserorassissance. Thekleipt essitlosotsissoiisobmohinc arewpasvssrdfcs yocroosmssloatioa

0-5Febrooey 2000 0-4 l’chrtnrv 2000

NPDB-HIPOB WEBSITE; WWW.NPDE.HIPOB.COM 0. QuERIES

l’c,aftraaiaai decutseaa moOed in ~err m~snindoo at the line ymlr mu in oeoisowed wish theHIPPO. If you ioseyourbl510 orpasnsord. ember theNPOB.HtPDB Help Line.

2. Cain I submit qoegiro Os the Hl5°Olt on d’sloelre, as I Or) for IIieNPOB?

Na Air queries sobsised to the HIPOB moot ho sohmieed oIecftaanieal~s rio he IQRS.

3. lficbnne100d.ordhinonreoetra.arespennr uaaqonmy,nruybreqoaqaeopyrromohe“POD?

No, The HIPDB esotetstly does see base Ore copnbiliryro produce daplicooe wspooses. Often didnon eeceisoaeespooto too query and “are nor charged for the queer the query has oar hceoproeessed by flue IlIPDB and should be renobonitsool. Once processed by nine HOODS, query

~Boon the IQRS, sand rho outky- still have Is eesnohoth Ore queen to termites roisoetnoe.

4. Corn I designoleor,o,erhoo eneAtoohonirml Ageotl squen formvrofity?

yes. llrlIlP0Bceroprmnee~ouancanrarcanmoruiaaemaI.4oo~dA~kfcrq~iogont•ty.

5. Is’s deride to dmiguutn as Aoolrori.zed Agent, or em change fronooneAgeol eoanother, lowit blur befoerthrAoihoeiaeol Agronean t,nen’ Porous organhearlon?

lIthe Meal is already eegiooeaed with rho HIPOB and lea been assigoedaD010, the tIlPoluwillsend rierifleadro marts to yore oogaucieartoo. You shoald eheala the ds’eneenninesoueethaoathdtoroaissn eeereet Your Authorized Agent viii be shiv in query clii yore angaobaeioor’s behalfentredlanety og us eree4ncofthe redfieatiatr docomeets

lidre Agetne is not already regioh,aed with tue I iPOB, the A~0Ot mr~ cull the NPOB.HII0DB HelpLine to ohla’or as .doiltarleeadAgeora Rrgisernso/on loner. Once the Reese is nogiscred.o 0800 redioassssard still he osoignod to thor Agent and the rarity cmi designate dm0 Aeeotoarausnrosod’orquery 00 OLS beira If.

February 2000

NFOB’iUPOB WEBSPPE1 WWW.NPiiD’HIPBB.COM E.REPORTS

or the Canal eairerne ocOro, or by fire close of fine mtirs”s area ssooddv eepcudng cork, tsl,icioeveris later.

lneonsIAngtheiimepeeisJfceeepoetisreiothefflpDll,thedaleoftheoneeewe,inquest’c.ssy~goulhe included, Sahtrdass, Sntodaos. aced Fedawl hohidaru art to hen included in die cotcrlalien al hoerperiods. (Oar nod date foesohmiein0 a heroin laths nor Samedas~ Stordac Ce Federal holiday, the duedare is die cent Fedensl web dayv This medrd of ecrepuneniot of oboe periods 6 roontoerut wido theFeo(arrantRtduofclrlljlroceaftn. 56,

The islcosrtat’oa requie,ed ho) he reported to the 11111010 it applicable in all tteahh ewe praclitiuoees.peavedea and suppliers.

The lIOPObI o~steon does our accept relnorlo noun do non include lofernonlionu in oil mandatoryBrOok Aaren’niev°u iacloofmatidoion’inroeooaniondoomuourelieveleoflisrepoeeirogreqoirrmenisrortheporposesoISecuion 0120E. TheH]l°DB ougecsrsdruoeoeiliesoblaiothe hd’cnroadco neededon eoeoplene maedaiors fields O’er die i-ilPflbeepotusas poet et’rhe’ar oppiicatioo process.

Time frame for Repou’iing Final Adverse Aelions

MaoduledidlP0Boapotneesesuscrepornsli rrnalads’ense acliots lalceosoo mrafleeAug’ost1l, 1996. Thisis die dutgofpsusrgo of the 1411003 iegtstat’on. 71oe I1IPDB eootoor oreept any errors with n dolt oforrios oaken prsoe to August21, 1996.

Civil LIability Protection

lit, immasiwreonisicors ‘us Seoias I 120E prierels individuals, agates and theirouthodned ogeots tenon&hnghetdlalsteheio”tlacnionsfeeeepeueotdelotheHiPosttelessthsmaeooJbeewleoreorraterymfthe bifonsadea The Malone reesialen the snane’osntumnr 00 050105 in mrrabsiaisinp the 1111008.

Types ofllnporbo

The flec recenrdertos adseese nodes submitted to, and precessed toy. doe HIPOI1 is eoosidcrcd the inidolRepros. Au 1010151 Repoot eentnins the carroll session of the report ontiloRtnislso 00 Andes 0° aCeorecoiotroe Void is salenirled.

Wlneo the HIPDB processes on loinal Report ssinsioed via the IQRS. a Report l’erofiraoiano decrasnnroois stored fee dre repoosisp redo to relieve though the IQRS. iliaea an Initial Repent is sohnsiinedoo

spDmrnpoa 11YEBSITEn ~iWW,NPOI3’HiFoB.COM F. REPORTS

Oven’ietv

The HIPDS arm asa flaggino ssonnon 65 principal goal i000pressso health care fraud and abuse and toinmorere the quantity of pcfinr cane within the Usited SLurs. lofanaeadro on Cased odserne acubos iscollerred hem end disoeaaioanol to eligible eotiaes. The HIPDB inl’sonatieo should hreoorsdeoed oddrthrnrglensni infoasrarisna’as hoe masneeimvraipauin,saodrrohosriogtheoedean€aisofoprcaudcster,poot’idce, me supplier.

lietdth plans and FedinnI and S eCooss aneetaneseiesareeespe.rosstslrfeeonproniog inthe HIPOD tealadverse actions uaheos against health c-Joe poclideters. providers, and suppliers. Flosil ealssoese aetietus

Healdo cam’retaled civil jedgueesns eanoeogd is Federal or Stone roust.

Haalthcaae’eelaiedrsiusinal eooviedgns entered in Federal en State rose.

Federot ste Stan, lic’eesittr and cmidcalians ecsiasut.

Exclas’mo (rein seticipafius ‘an Fojeaslee Stale health eaton peogomo.

Arty ether adjraailconed eeui000 ar dacioloosrlot line Serrersaty doll o,nohlhoh by regttlanicoo

SolOlernenos to o hieh on 1000iogs er udm’oaious of lialtti’iiv hate beets mad rare suootalorieseloded from Isniog nrpoesed. AddiOonally, aeuienswinh respect no atmiteal rnalpenefireeiaiounore nor ntporaahie oodrrllte 1111008’s eoablingsraioir.

Allrapaoesoiumbesrbotuedeinroordcallyuothei tP0B, Repotnasnsyheothoeineds-iathelooeoteerasirsghe NPDWOIrPOB integsolssl Querying and Rrpeniug Srrriee(OQRS) olwowr.opdh’ltipth.r.soor. scot

diokeane iso ‘conan speriSed hythe HIPPO. iloelatenface Cmrorol Donranoarl (ItO), tsldelr siseeirtts diefmmssal for disrueee sotroissitra is asssitablc coo fine NPDB’HIPOB trebsire.

Official Laognoge

The odical bogosot ofnJmlbtpOll is English Atldsoassmnsnssa65niuedraflnetIIJ~O8 must he ‘tritest inEnglish Oecuornreos suSoniend in soy other longoore still oar hr aereptedi

Conupratation ofTime Perlode

Heslthplaets aunt Fodcgol sad Ssoneoevesmtwlaeeociesmus, reputnftrnoladsroseacdoostothe FOPDI3osidrint it eaterrdar darref the date the oclioso san laths-n or nheolate ‘then the reposing cellos l,eraone

Felsroaoy 2000 E—l

Nl°DD~mp08’vEB5IarE WWW.NPOB.HIPOB.COM F. I4EPORTh

diskerre. the Report r’er(rirsesn decornteoan is sent B floe orpoalinog rsniiy via dc U.S. I°oslal Serstue.Mjigcosllt’. o,Vosojieaaaintefao Reporu mole Dar,uflanflfr) is mailed sods, orbjecnolthe opens Therepooning natty and the sul*en of the epson should resiesr the hfl’emnatiiro hO coaster that it is esirrect

A Coreecfioe iso change iorteoodod too tupennede the eroleots of the concerto seethes ala epori. Therepaitgoaitymostsshmieotmriattssanraspeoihls.ofleethedjocuwryofaoeflererenthalcoinserpod. ACweeciieunsayhesuhoginirduoeeptoeetheeuiwniouofaeen05ep~to~..,~.

When doe IOPDB peewesses 0 Corrucfiam subordnted Satire OQRS. a Repsra VerLdnu’aaeme, dorurtseet issinned for ire reissuing entity us teloiese doolteto the IQRS. When a Cesecrimu in whosited at diskette,the Report t’enrfsruriaao dorsarent innt~eointheeepoiisgeeairysiathe Ln.S.Protai Service. Addtfieoainy.a RrporaRsszsese. lola/ed mrSaasltatCttoegedinoer.onauistnoaileJtathesobjereofthgeepo~sondioalIqoerlees tthateeeived tire poonieos srsimtofthe eepotisalohbr thepasu3~guos. Thereporoiegeniiorasdthe sotbjeet aithe orpeeo should resiesr he infmsronissttco etcsorst thanr’tsrsrunecl.atdqueeiertshetldnolethe rlranged report

a’ Wood rs floe oensaricou era repels it irs enthe . The ingest isretooved tietrt rite subjects diselasablerecord, A Void nay sm mIstimed hr tine reponihna entity at any dune.

When the I 111003 tsscesces a Void snhtoited go toe IQRS, a Report Vettjleseriaro aleetrraseor tasnoredfoe the reposing ertity um relieve flwongls the IQRS. Wiren a Void is solassieed on dttkeee, doe Repro-vl~eofteor(oss drraerreoor in seoul mInd repealing ereilyvia doe hiS. Pienral Scestve. Additieoalhv, a RepranRen,i.ueoif O’asiskd.arseootsrCtestgeddscuosnenistoe.aioectootaiesrbjccsoforeeponraedtoaltqonientth000eeheddtopt%iomveoicooftheraportotidrinthepase3yeson Theeqmoisoeethyondthauahjecuof the repoos sbotrld resists the infosonsiiet no essste than Ira coffees reporntvssosoideni. and qoeriersshould orate the void oldie report

Revisits to Aetino

A Roeviden in Action is togs’ rrpott dnrotinganaeflce that relares 00 and eoeohstrn mm ads-rose ratesprevtotnlv repssned to doe MInDS. The duty Oust ttpcets an inhiul adverse aenior beam also report asyrerisiontsthmaahoa

Essmphassb’Revosisors in Aehior itnelsde tlotnginaanasererlaticerwedreexenuio,gfanaehtraianuenao Oos-eemnae prima erdte onrarensning afajsdhr’ml setirn. A Rn-bios l.a Aetino should not horeporled onhess mito iuhrini anton was reported to the 5IIFDB.

Fe bro an’ 2009 E’2 Fmbntutv 2000 E.3

NP010-HIPDB WEBSITEt WWW.NPOB.HePOB.COM E. REPORTS

A Revisioi to stories is separate tod distirot from a Coereccisae. For eosoaple. ifaropcedrrg maicy storesa Date of Action iacoreecaa,v a Ccaassctiai raso be submitted IC maSse the aeeerraey change. sad theCnteecfioaasresssstesthepresisas eceaicaofdreeepert A Resinim arstodoe koeaoedasan addondsmto the preojoas epa”. hot is Wed as a separate. disOrl aortas.

Esanaple: A State ticesaitig (‘coats cabatits are initht.detoe,aae Action Repast ‘skate at stipends a canepractidmeealtceease fare period alSO dave lire osamrenrsioaa is later enlaced ao4S dave. Sitter this isastretches that madifais a peeviess~ repotled ectica the State Iicorxstrsg bested morn sshsssis a acre repeatatshsothtRecisitotestcttmaptioa. lltelsitaaIRepeddosaanenrsthatthtSosctkeosh,gbaosdsess~endedthe pmotitioasea’s Iiecaao, and tare Reviaiea to Action docameraR chase the State tceaasine boast made aresides to tate ptesioos retina.

mesa cite t UPOB esercesscs a Revisits as Action safrseiated via the IQRS. a Repeal Verifloaareoaedocareent stored for the repealing etoity as retrieve theaagaa flee tQRS. ‘(‘lace a Revislee to Action issxaanstacdosdisketae,ehe Repeal tteaaflvaoioaadccuntmaxis eectaothcavpocairgaeaiavviothe eJasPostalService. Astiiaeioaadty. a Xoaisseaaseoiassfo Report the the Data Baaaatha is eraited to the subject of therepeal. Theatwaaagmthsardthrrsteestafthetpetrxsboaddroctoxtheiaftmxsilosaoercaeeom,itisCorrect

NanimorAcerel

A Noise ofstppoal as a repeat rv,eifrmg the FIIPDB tho a stabject has Feasteaty appeated a eresicamtvttporned adaeese artist. A Notice ofAppeat as separsee cad dioiect ulveaaaabjeec’o atispuae na HIPOSrepoat Foe mote isFotecaatoa aessauiac the KIPDB dispute peeross. refer to the Dispaaes necaiaa ofthtsOeeiaiebook.

~ViaelstheHlPOBasooussesahtoaicraFAppes1snthaeaeeduia,JaeIQRS aReporo Vita’ifieat!aedeosmraais saomd foe the assertive carrOts, a relieve doormat the IQRS. Wheat aNmice ofAppeat is saat’aaeterd onatac*eate elsa Rqassn Verdieeatiaaa decameot is seat as tee repeating ratity via the US. Poatoa Senior.Aeiditisoatty. a Report Reriseali Voiokd. or Pastas Claoaaaseaf deosearax is mated to the naabjecc of thereponsedaaqueriersaslsreceisvdthrpreaiotoveatsoaoftherepnwithintbep~s~3veaea liararsathsceetie~asd the sabjeec af the repute aiarastrt review else iecfomtaaioatoeaoaae thaa it is cetera, aridqsrriee’ shoaad cute that the scdora apes actsieh the repeal to hosed teas beat eppeated.

Report Proecsaiag

Eaehveesienafarepaenpeecetsedbs theFflPD0compstera~saemisassigeed aaaiqseOccaateoaCoflootNumber (D~O). This earthen is eased to locale the repeal ssititia the etlPDS system. Tire OCN ‘ispsoatthrenrcFj’ dispbyed costa repeat ctcsaeesrts The DCII maigned to Ore nest Cstveea ‘stetson ef theeeperame.slahssys be refeseoced ha soy snsbxeqaem acairn bavotsieg the report. Fcrrissarptr, iron eatity

Febraaey2oaa 5,4

StPDB.IIIPIIIO ~VF,ltStTEs WWW2iPOR,llepaaIS.cOyi E, REPORTS

Eeaaapleu ofRepostable C,theeoal CoaeaOoetaeaes

(Ilee retasaubegra, aemod da’etpeiorrs ofcatrbaal voasiodors)

A stated health basthaeieta lsoeasicted aloeado.bta pbs-tiodtv absaise etedeeds in coatsollieg Fetepatients sod is sesteeced ton bate ‘roe.

The OtefEvoesOsts oak5, oraawath pEn sliecised phosicioss iscsasvietedefemfrenjsnerslaosithe bastes plas and seattetccaa ao4ycars spates.

A ehiropeseror accepts kickbacks Fears a aaedicat espp~ cespaun is csohaam fcwessdeateelessteBode else cbitaaasasoaee nod the seoaicaa ssppty eoaltparav are casaestcted, aed each isscaaaeaced tooS20.aao rae.

A paoceitioaee accepts snail scans of motto far rofeersa to a spectatio. the olferse eesclts iradithered cancicatos itt which be mesa saisa5’ a 2-yeae peatsaaiouay period before the cssaeiedoa isdropped.

AtheabteMadimtEqaairaeettprsMrecoepasvtc tar dssaeesakcfp!esdmgssthyroaeeeicbtgaaialeesa k’ackbackefStal,Bos. TheO)e0eieoaapscvreeatived tee kiskhrokpayaeeocasindaoesreeato peareat atethee DMR rsppoeo cx provide i0000iresce kits to Medicote beeefaeiaeirt mastbeerwiaaiesaivralieacbsofcoashpbcnaesossnodbydresunlemsoepcasrraassaaaeoMEcsxepansAs a eesraat efasae hicklocts payment, telrdiasar paid approximately 53.6 mullet for ireoartbrcacesoppites ashiest some 55 medically eoteessat3v litre colas ordered that the cempary pay a floe of5292,deO arid thacthe defecdaea eorpoeatiss beplared es peotaaaioa for2 yeses. Ocdttg thatpesied,do company sass directed aa trrptemea.t end sutstttt to flee coxec a caaperaae eoaepiisaxe progearat,isetrolatg a retardate for implemenotiee0

Ties osstaeeofepetaaaes of also separate ambaataace companies acre ceoeeced far their pastasMedicaid airatti seis.rae. Eaxta s,osseaaress.edro 2 aeeethuaadoaaedsy incaecersriata tobe fetlersedbe S vain’s ecpecsised peotsatieaa. sad ordered as pay 52,000 ate eesdtarios. The mattes pseeltasedMedicaid itfomtsriorcsa)dclrideetirtedaeeipteoats aita had lseeaa asaspetried to the Fetpitat tao can orby pebte atasspeoesriott, frost an itdtsbdast suite ssoalsod at a seal hsspilat. The aanrns tied doied’arnsalice to create False cashes thm bitted Medicaid fur ranbtstaace services .sifich were severprovided. They received mere hate Staa,tte° as a resstt of the fetaeetaieeas.

-Amsosass seetesced for eerctpbacv to oshrail fake Medicare stashes in comedian with ha twodeesirle neediest eqrdpocet (DM1) companies anal hi. arediest diserstotic coeapsaaxt Ills sentenceitictadeat 21 tatrrrhs isscaeceasfiom, psyttlerac ef St statues be eesaitaeurse (caRtel he w~r arssaey thoCkscorsaearc eacaxees feats the sate of hia tasase) road S tanes sapersised aetea,ec. Fecrra a 992 to

NPDB’latPDl WEBSITEt WWW.NPasWHtPDB.COM E. Rr.Poeas

ssidaerroeoeecaaalrddd Repoctitsbreired,threeeitymssaprosidedaeocNofahareepoacssheataubeetilaiae the Ccsnrecaiss lathe alaPOB.

MWDB esautmes as eapeess saabarsieed xis the IQRS are asentalty pmcessol asidain fear to ass Feats.tHroB eeopeeses to repress sabetitsed on diskoec sac sent en the aepeatirg caries via the U.S. PseatSen’iresvithie to (“minors days ofeeceipa,

tfyvrsnabntharegenrstheHe.poaseas iasaocsxsitsblo feereariessaaastssthr tQRssaidaintibsaitaess~~ or ifyoa aaataiaa repast Os diskette and do not receives aespeesse asirhia 20 basiaacsi d~,. coal the,epcaaa.aaapoa Heap titer to eeqaesa a report Carat.

Repoaling JeedRmealtk or Convictians

Hestth caee’eeiacedjsdosr.ous sod emsictises that mast be repeated to tire DumB inebade: ctitnir.slcaavicttars,cbiijadomrors bsjaoacrims, east aol. oorrsoaelere/na canaesc pteas related an health Care.

Federalar .iesee Ftea]ah.Cara’Retaeod Crernanst reesleetsas,

Federal, State, sad loot peoseecroas moto repeat crbsdna] ceacictaras spates hestet care paaaifieeeot.peocideas. med supalirra relsiect a the detivee afheatda care items or seevicese. Section t tIRE defomsceimiasatcenviceiocssdcacsihedinSerraien aasggaefalresoaalseesesoAcr,

Pettier perposaofthe tltPt)to, a criminal crassiedos tscaasaen tltolrcssos:

- Wheaajaadgarnsa orcoeasicaias tars beexeareeed apiasa elsa isdisidual ctresaitv iaa Fedeest, State,or kcalcoestreeaadk’ssrfrstaeetaeefieeaeissaasppeai pendiagcnasirethecthejsdeasrtecoecorvsctinaor othec revved eeaaaiar to criminal eoadoea os beets cepanged.

- ~Vtaeatheaelsasbeeealtmltogrfgsitraesiassttheicdis-ideaatorenritx ieaaFestmst, Sasae,srkeat coast.

Wtseasaptmafgsdkyccnalaconaeeadeeebytheiasieideatoeenraitvhssheeeeseeeprcdhyapedeasj,State, on beat c’oon~

\Vtaees he tastividsat teaadsy has mttered into pseticipaliaaaa ins ‘tarn rfa’endee. defeated adjaadeatbaae,en othee ateaoneraamaa or protean ashenejasdgtacat Pr conviction lasts tees ssiddteld,

February 2000 P23

NPIIII-HIPDB WEBSITF,s t,fl’nWNPDB.MIPoB.COM F, RRPORTS

99th, the eempsay assaser paid panirea recmitess no halite Medicate besrfacianies to eeatoia Iiecnaedphsticbea sshertt tsr paid’s ardor DM5 ard disgpottio Irstiag. Tloeragh (‘is eortaasaeatts, ate theasebnrteed Mrdicareobiassfoeoviatssdashnxnesasrsesssaeeeneaarnagnedoraeoaoamedicstty

Two leeaaae assaxers ofa borne Featth ageecy QIHA)aeer reareoced for paatieipaatsg ira a scheme andcfaacd Medicare. ll.000.osstteasiretaded$29A000 iv expenses aocectstoslto patient caste ta Olincosanepeats. Ttsesecapssteessaeotfscitieesivcra’sreedaseomaliagaredsaataypesetasseoFaeailvsndfaiends. Omnfthe HiM n.ooeasssas aeareneedaa a roosdas iseeoeceeaatorr t’ettssvedtss 2 utotattu ina hslFssasy haste as pass era 3-ycee otpeesioed release pmgasane. The other ssss sentenced to 5maasths iopeisosaresr sal 3 yeas supervised aossbariaae. The owners ‘sear 5mev ordered eo payeestitatieea netting S244.422.

Ertarrples of avaae.Repanaele Criaralaot Crattieoeras

‘Advitjsdps.as ngskaagtysickss isarached farneediest mstpenericeaed thejacysrssods 515,000to the ptofrsof

A peacaifisreris fasard an be stdicted tan draw ard instead af heiag cotsiclad fee oBsession sadabase, the poctiiesevts gist a deferred ccataxicaiar and is arcs an a eetaahtitotiee facitit.

aFederal sad State prasecurea, sod iaavesaigstiveag,rcies most repeal iajseeniras agairo areatth natepeecainitoacra paevideas. sat suppliers. The iajraaetios mast be related to dcc detierry af a iteslth cart itsaaesenriceno hr eepornahlr.

Eroaarple afar Reporitrbte Iaejaaralaae

Aptsaarriealeampsnvdstcsadmgthsapaodacalsnntfet sideelfectslaesenoa.evcrdthe FDAiaapeses as btjoactissto uep the prudactiso of the dmer

Lveaaaple ofo Voar-Repoereb(e fajeracoiro

A xactideoee basset byanedan bepaaed ar,skas’a hits tfli’s taO F; suitcase he has (‘eec massing

Nato CseaenteereaNo ConIes I Plea

Fesleat and Stare peocecutces sad ins’estieadse ogesdies mao repeat are!, s’oaea’asloro’aat cenama pteasbytsealdacaasepaaedniaaers,peasidees,andsepplieas. Apaesofeetacoaeeoer/erebasthessreeetleetas

Febrnar’s’2000 rebnaa~’20ao

NPDB-IIIPOBWEBSITE5 www.RpnwmpDs.coM II. REPORTS

a5da olgnihy us far us the miasmal sentenc, is cosvraase4 bat may eat be ccsssidared as an atintistran offoeawoth,rpsspose Thee000ee,sdn-r’omomesspleamustberelaeedtethedelivervolslteahhiseuss or senicescs Ste sepresable.

Eeauqsle oft Ru~enableNo(o Caooeodere,i~hs Costless sPies

A psacsisinnee pleads ,ssslo vossrrsealese Ioijssausases fiats] related to health case.

Krrsmple s4a, Xoss-Repnriable Nero Cssuie,,deracve Casters PIe,,

Alrasiderplexdsssalscusseris&ertninsennrefraudsasuelscedsoheajshcase.

HmlIh rare,asebs,d tied ludpemsss

Pedetsd and Swie stoesean and health plans moss cccisfljmtsspdnsshthcoaceitiacess.pravidnrsuplissneLstodsadsedelvemefalsealthcanftansorvire,peprMIon~fls~see tisecimiljsdtnsoe is do oathjccl oft pendissg sprah Ii, atvemsteec nectary is past lea rnuli-clais ass clvi]judesnast is mon manse the rerposnihitsy far reresshsg the audio nedon, hschsdh,g nil atasnumisa’astdedcia all the claimants, both public and privast. ~V]senagnrensnsenl agency tc snla puny, ban here seem*k health plans as claimants. the health plan usisida receives die laus,css anon,] is mspoasiblc furrepsvsnisgthesocslaclios fccall ranks.

Exompleu ofPepansshle Urn Iudgsssents

- Ajsadgsnmrnb standeogamsu clinical labsoneasy, crushing in a $so,oan assued ferfnosdtdmt bitengc,sl miskasding eseds sisg in a suit hrmaghn isy health lussatas and health case payers,

- a\jod~ssaeta ngaiesl anaeshglv.sune imposes aS]O.Oons’ee forneglectaud frrfuilnsclocdeqsaselyclean the poaiestsa’ tsoesss.

- Ajsdesssaltagahnssanmsskuluenespsa]Laucesmpusnvsesstss issSaO.Con fine for isOng raise sodfcssolakct claims and straining paamcux for neshsstsece seauspesiadon so desshtxie,sa ret pees,inalby lass; ret medically secessar, ned foe palierlu “Isose atebtlasasy state did ret requiem sach01055,0 eta t is n.

- A healds plan dues sslleovercossresie peecedures. A plastic sturgeon misrepsesessts us health pins’usessnhers tins a ceala a type ofeossnesic sergesy incassoed by herith care isnuennee although is mess.Etc member has &e essornie usga-s, The s,asgens rends is the clubs so the health pintsssiselesaceea*ier she esegesy an a resseesoeede pseces use ssnai is paid by die health plan.

February 2000 c-B

NPDB4IIPOBWEBSUE, ~Vww,NpoB4olIslaB.coM F,- REPORTS

reedeted ha s Frdeaa] erSsase licensing srceaiilcatioa authority, such ma escisasimor revncsliaes, orsuspeesico oil ancreatiticadoa dust mccxc ‘at manjunedan svith aerbusccis is which sothudiegoflithissy Ins beau made (aiduangla such a settlement itself in sec repesnabis under the snthie~ Thisdefasi’eschdhnis’•efs~rmudmscstTveasionplSdotha~~meluclim.sudess Isey one eosssrcled sin she bilie0 psocisies or deliver> oflsealth cane seesices sad ohm inenejusrss’nsssith other liceestee or restificauien lesions sash as resocosien, sssepcnnsios, ecaassae.eepateasd. probation, or sssnasda.

Federal and Stale adverse lieesss,ane actions are repsseed under the appsepriaelicenosrecasegcssynntheAsdtxrae,iclisne Report. Adoeeseacsiega ralteawids eegaed cs a calidlcutisst agsersiests or cesssnacs foepaesieipatieo in Federal or Sete health cute prounram ant rerones] under the Coversnnxse Adminianatiseartists cslegoev en the 4ohv’rae Aerials Repssrl.

ExasssplesefatepesriobleAcslsasss

The fellassissg adverse lice,,nnee msiesss man he repealed to dse 1111DB:

- The denial nine op5slicaliott ire licensuse (snirial or sesesssslJ.

- A licoapae diseipl’usuy actions Ida, ha a Stair Liccaning agencY based upon the prncdsioocs’s,presides’s, or supplies’s drlibasste failure an report a licrsnssaae disciplieaev union takes by musherlicessistgaga,cyssthen a sepen of testIs aenicus it niqisesned ona licestssate ncglkadcn.

- Volunlar>’ suereesder cia licence.

Exossoples nfMas,-Repo,issblescsiesas

The fdllessirr adrone Ileessase aclimn thoeld eat he repoeed so she llll’DR:

- A sealmasene agneemese stisids ‘nsposes*e etenilosing oft psaaidoner. ptoeickr, or untidier icr aspcdfse pofsene,ussbooshmomaenngcasstiwnsnsesaietionesdselicen,saeerisccauidcardlobe, reprimanet

- Alinensmedbciplhasyactionsetsis1ahhssyoaissithasnaf~cns1ingceunp5csi,sofspeeifsepogsnass

- gm volaatssy eelinqukhuneet of a praclitimset’s Ikesse foe persona] reasons tuna an relitement oreksage so macussr stains.

- l.iceastsee ersisea sahm against sms-lseaith care practitioners. peevideen,orsappliens.

-M hthialastdicntiuu Iorliceease-einvsthirlus riosician has failed to pssnthe seqasined liceasureesass,is see accepled by a State Medical Bread. Is this osse, hem ians fesmal or et]]cial setk.u so denythe lirensr. suakiur Ike ness tsss-repcetable.

NFDR’llIPOIt vVEBSI1’Et W%fltNTDB4Is]’OB.COlll E, REPORTS

Snhseqaestds; dse lsealsh pleas discovers the fsatadulest clnin saaldaaes In eeeos cc die osesnoesstA jednnsent a sstedeeesl asssssditta the health plaas SiOO,00l.

Eceessples ofsveis.Rs,pnnehlr Cirilsoodps,rssrr

- A~tgnretaiteprsanu5]0~ ioronamedkeJssppliesas~arpftrls½irdiscrisrisadee.

- A judentert efSPla,000 is sesdered agaiasc a psacuisioacr foe ssudIaa] tnalpmclivs.

- A sesoereees Oat is eeadsed ossnide the ceoct

- Ajoignseansapaiest a paacdstnee damning from an outnstebile accident net related so the ddisavofa Itnalds case iscsn orseevice.

Rcporeisag Adverse Actions

Adverse actitna that ssses be repased so the IEPOB include: liecosues acId ecsifsratinn actiass,Oosenurosc saeato care presses cesaitotion acliosa exclusions foom Pedesal and Stile health caneps.srssms, tssashh case miased aisniral renvictioso and cisiljsalnetssssls. tad other adjudicated actiessseedenisires as esuh-lidted b segothatios,

AdveneLimeusreurcepsiseasioeAasitan

Federal and Sole liceas’csg and cestiicaeins aemcies ssssre repast foal adverse licessam ucflnss takenagatslalsealdueaeepaelhtaecss.prosids,oessqtptios, A scrosoble fssal sdiseese lieesnssat settee massbe a fa,nsal or official aOies’, is seed ore he speeilically related to piusfensiconi ccsrpciance or cesdavs.Ssclu actions include, he ate seat lhshed so:

- Fomsal ereltcidacsiosa.aaehastheresocasiesurrsuo3sersinr ufulicesseorerstifseatianagrcanessuor cosacacs for passcipaliuss is Federal or Stale healds case psagsaass (and she krgala of anysuspensinni, mcpa’ansasd, cesss,uia cm probation.

‘:5.ssyodser lass uf liresse, eeatfscalion aceeensesst, or contance far pa’ ipalios ‘as Peulersd Dr Stilelnelthcasesxosnaas,iorthesighlsaapply foerrcescsrslteemenrces(uiatiesusreeerestopctsssaceof the practitioner, provider. er supplier sytsedser lay opesasioss oftaw. voluntary surrender, cussenlnsat(esclnlbyaosmspasts dm sossanpa)sncscofiersndiressms,nrcllungeloi,sacsistasaess),

Asyotherecgaiire uctiasee fodatr by] Federal ste Ssaseaeencr’shss ispssblicly mailable ied’restalionand is sesdeeed by a lireesing cc cestiftcalins authority, bard teal sad Belted ss, lhssitaiioes cc theseoprof paactice, llqlsidaaiass, ~sucsiasst, sod isefeitrses. This abs includes faa] adverse aedoen

February 2005 E’9

NPDB-tIIPOB ‘sVEBSITEt W5555’ta°iPDB,mPORCOM E. REPORTS

Esd.ins.s remus Psesudnal’ ii Fes]er*Stnse Irealsh CaeePmpeassys

Fedetsl and Stale agencies muss repros health care pssclasinsers. providers, am sap~slieos excluded fromparticipating is Pedesal nr Slang health cane puesaans. The lean “exclsssion’ scans a sarepnaq orpeasnaaeea dehasrtoe of an hsdisiduat erental fsoaa passicipatics ‘ma Federal or State lsralds-tslascdpmgsass. haccardancessithnstsiehilrtnnsoesersicenfm,tishedhyatehuxssanoeectisvssi]sosberriesbaased asdee sty Federal ur State heolth.related pmagaaen. Seesioa I 1250 lesiss the defadsiarofFederal or Slase Iseuslals care psogsnsssn so these psapeaass defassed in Sccsiesn 1125511) and 552811’],ms5’, clv. of the &scial crest-for 4cr.

Enchainns fran, Federal or State healds cam pnoerases me repealed coder the F.vclusiao or Debaan,tmscategory ass thsdthxr.ts’ drain,, Rtspstre.

Eeuoupoes oft Rc’porouble Evelaslsn

A nunaidveer is enclisda] attn a Slate hiedicuid jeossam stiorpleading psilly so fslieg falte claims,

A phaskias stat indelitsasely exelssded front a Stale Mediraid psegs1ssu hecaose ho susudital licema sinssnspendodisTe,aas. The dnctce’s license sus~scesinss san due Ia stvoeal ce.eplaipls. iixtnding placing Ianopidnud catheter in a patient’s tts]smeu dasisg child binds, isssead ci pratantly placing the cattherer’m thespool canal.

Ksatuspkofo,ioss.ReperoobkLvclssisan

Apsacthianeinfmutd guilsy inssiaasbsat penceedme of dieg false clainss so Medinue,sssissuo exclaim]leosus Federal oe State Isealdu cease pnoksaan. This ssaatd he repeatable only nsa lsralth’case’relaedcas,xsnd cemu,iaa

OsherAdissdieuted thctiaes or

Federal and Slate Govesseasenl sgeac’ses and health plans most refon adjsalicasedaetiae,s crdccistauaagainst Isealds rare poacssdcners, providers, and suppliers. The lens, “ethce adja seined actions ordecideos’ means:(I) fassaaterofticsal final actions lakca ogaiaasl u health case pracsitionrr, provider, a supplier by a

Peatal or State Oostununscssa encyor a Isealds plan:(2~ ssidrh include dsr asnilahilisy ofa due pravess mechanist,: and(3) london aecvorcnninsiots ant atrormorceoidoifecs dIe paannsts, povh’sc.ordcliservofahealth

care item er sen ice.

A balbeasieefm-saldudjseiicalcdaclaansedecisirs ‘n dseerailah(knyofadarepsecmsmalsanbam Thefact that dte sssbject rIctus inns Is use the due pscecss nsac]tat’ms peosisied by she sasdeasinc hanging siteacssas is isumatesial, an tong as nach a protean ‘tsaruil~le a dsessthjeec brfsre the adjudicated action orderision is made foul. Ia geamn~ lion edjudsvated acsisn mc decision fellossa en aaosey’s rstsh(ssbedadreasissannise procedures (alsirh mtaure thandue process isssailahle sadie subject ef the fund adrosseactiss], It asuold qualift nsa reportable anion cadre this defmhion. The defndean apecillcaty rtscledactnisa]psintegbnracnixsasatas by Federal Sr Star Gosensnan ugesscieo and vhtbrpsaeliagdecisiaasmade by health plots. For health plans that ate tat Gacasausant enlillea. as acOrn takes fallossingadeqaaaterdcenndthccppucamh,.fsfalunaeeOcamesthe,ankofdnepra,eesscosos,aiss~,ira112(bbefthealcQlA(42 U.S.C,lll I2atlatso,aontdqtalifyasaeepossableaesionundcrthisdcfscidcs.

Pohrua ey 2000 P,’ID Febnaauy 2000

M°DB’IIOPDB WEBSITE: WhflVYPDB.HOPDRcO)l 0. REFORm

The le,nsnt000a be a hr~ plan or F edeeoi or State toatoy of a paucuidase(soornroce to provide healthservices is eepettable to the IIIPDIS lit oteens the def,abioot of an “ether to~sodicated action,”

Exooopks ofRepeolabk Ookerddje’dleooeddroOeonv or Derisine,s

The folios is0 Ott o,poeiabbe then thor meet the eeftesia indicated above:

- A health plan Itas a pselknod provider coasacs with a psscldsaise attesting the p~ch’atdso On bed’reotlo eid hr the plan at neacuiaaed touts dx roamed psyehiaaic setvirea to be sundered to piaanseonhees. Isis d,seas thae the pnvcluissrtot iavess,allyaismjngldopa,ionts. ‘The health plan, pearto a cniniind ,djsdjca,,ae, teeles to hove the pavehiatuist mteoved as a contracted praethieoer bytea,nitath,0 thepavdaiotaistboansacess’ith thrhcolthplan. lftbenotintagoiasnthegnveisias,isi renal’shi the teaiontoticn oldie psphiaaivtb ceto,oct, this ‘mold be copottable. In this ease. the ccateaeltetn,inatiess isropviiahie, not Use heolthplan’are-oyaaieo olthepo~thiaIrinl’nol’ss’enl pn’vilegow

Aheathplahasapoefeesidcrrooosa005sid,asosogaaltswisothesnegeento&dire,ojypaidby lIst plan at negaliatod rates for coveted s,e0icol services to he rendered to sIan membots.Coscplausta art rereioed by thr plan cegordino &pomr qto5~ of the orgeeods senloet as,! patientcare. el3tr horn0 the epperlam’ey to be bra,,! ov0andng the atlegadnea the shn temsosales hispstaitioterrees’acobasaj open qnality of torsion and poet polinit raft.

• A health plan rernonneheeloted aaapertoivn “idiot, pay spans, a Fneetili0000.

A Fedrrot or Stare (isvenanec, Agency eedtotlrn in pay action apainsoaeescelonnoe.

- A penosset’relnled action suet, Os ‘edartiens is goode farroase.

- A ponsoasttel.edated adios taint, as a teottiratlea.

A federnl nuttier (iovensnont ransom ten,s’natod for

&rnnnptrs snf,Vnn.oepasrnebk On!,,, AdjndirrnedAriinnnt one decisions

‘Moveqsavnsetndesennistattona0oiacn npeaetitin’,er made bya Federal or Stale Gosotoancnr hetlthrat prog000,: its enettaotor, art l,ealth plan.

• A denbtofctain,deteneinaoon agalestaptaolitianerenodelapnprdorsl orfitatedos’ennt,encteal,!, pltn.

‘Asevoeatia,, oft plnsiris’sctinieal prisileees by a health plai, n’ Federal or State hospital.

Submilling Repnrls lathe HIPDO

The 1Q05 is designed aneolatme an oldie neressny information fee the sesreessflat ashossisnion ofdndrrrseAction Repos’on and Jorpgn,eoe Os’ Conn’ir,iann Reponeso ho HIPOB. It is is, dent to reo,es,sbrr thatif a teen,! is inrompteee Ii a. infntaaadon is satiation is, ‘equine,! l,rlds), the QRS does ate nltosvapepo,tto be sshn,ilheJ to the lilPOto nntil the missing irfonontfrn, is addedi

Februon’ 2000 0-12

NItDB.TISPOH WEBSITE, bvwW.NPDB’IIIPDRCOM E.REPORTS

posnoge oldie HIPDB Igeislalise, The dupes ronessae arrejal s’rpor!s ofnrtits,sn token before.1nynasn 2!. ‘996.

I Wtnatisthrpenaltv For fsllnre In repnrl on neninn no she IIIPDB?

Health plans ate nobjeet too Inc efopla $25,005 foreaeh foist toteport. The Socalee shallpmelorlhepirodoiofthrnaaoesofdse605aeenntentaoo,thaeftiltotopo,easeeqnfred

Win tIlPDll mandated reporters so ho also report a tsr NOun! hove In report II,, santenotion separably I” the lane Data bus?

Na. The statute roqoibes that the 1100DB ho isstsle,eooai is antannen thae assildi the drpliratton oftheorpotenereqsieceeenuosrabtidtsj for Use NPDB, Therefore, eutides that eslettepoteornonseaboth the Nl’DB and HIPDB ‘sill srhntil earth repels coca. Site 1Q05 win the, oet,ostaiicdlysmlrthe rspotrs to the appropriate Dab Book(s).

5. lIons lone nor reports held in bite HIPOIO?

lnleos,tnnon sported to the IltPDtt is ntaintoineal penisarruol,: oelv’ss it is rorsedod or ssytdrd fOsSnthe syalna, A Conne,-tia, or Void teas’ he suissieed oily by the setxosieg eettly erat the dreolionoftl,e Seossitan ofHHS.

6. Can mvornooleorieo penvideorep,’ofo IlIrDo reptsrelntltosehjcel proeeifasner, provider,Or sopplter?

The HOPDB a cia es e,tdlies dsolaeeetpt to eiaimlahs on rpm esrlnarge saint, subjects, Ha,ssrser.ilpon msideoeovolthcrepeutwdseso~rthesnrehaomm,osenroblib’aoevt,roepetnoon’sData Bath ldrntiticknim N,ossber (DBlO~ flag BolD suet ronsako eonsdeaatiid to Use ntwasizsoiustosalt,ch it is ossigno!.

7. I’m irving en .-epsrn a pr005ilioner ‘she did tine attend a Prefessbonal Seltool, hot IheProfossiootnlsrheoot(s)Aeeeo,eird and Yearn) of Grnolo,,Non field soar nsaedoeney. lIonsshould I complete those fIelds?

Place “None’ in the floobsstsnal School(s) A oen,lrs! f,rtd and gLade the year the iedisidoal “asrpprossd or less licetrJin the f,etd in the Darin) of Greoieotios held.

Repoelh,gAdiv’rre Lire,,s,,reAetleor

On, lbowoheotdatoolr800nlreporiaoaesioesoinhsesemllrs’etoere’ampoe,e,s,fnr htetone,lirense sespenslsa,, fotleoseol byoenvoaeor prohntion?

teBaardahonl,!se,tllsooederrthenri~srneoiono-oosioasoaddosseibeits loll order,isrhedieg lesser actions, a the cannothot of the .sdsrraedrfto,, Report, Am oddiel eat eepott is potsseeesnorp’ what the lesser soecsoes eractsees ta ieeptanetrted, sitter a nan oeeloded m dee desreopteonhtthelsdmlorpon,

9. Ptotr should Stoer Licensing Boa,,! report nrtiot’ssshon obey arorha,ogrd by eonrt order?

‘lie Boo,,! satotdd repo,e the i,nit’ml adorsse onion as total; thej,tdirisl deo’niss is rcyooed asRetioioo cc Action, for example, ira Boood reveLed a pibvntrias’s lironse and ojodteioi appealresoited in the roots medi55nt the diseipOlato s~pnoboeon Use one year, then the Board ssssld beteqeerod to roper seth to tntt,ot reseeotaan oct00 and otte moon-ordered tes’Istoo to a Oee’year

NPDB-HIPDB WEBSITEt WWVS’YPDB.HIPBB,COM 0. IOE5500TS

Cboeseter limits

Fad, darn fold ‘melee 1Q05 is limbed toooosain toerbor ofelosodlea isetod’or spares at,! plesesmt’onDab ore reeeesscd 6’ the HIPDB s3sseau esmeily as they ate sobmittod b1’ the vepeetisg n,lits; theHlPoflssiloolchnngeanydosaieorepore,

Threorotis’edeseei~tien I’d,! cItes’s these ais000dWeoeonerspno2h000kaeontetsi iurloli,n spacesto,! pvtcbaahae. Amy ehseootees 05cr the £‘OltO.chtearter limit “sill tmt be accepted by the IQWS.

Alregaboddaeoret,!aidettfifyis0 the sabjevt of tic’ trpnre meat be completed hefete the repote con besshmt,srd. Repotleen sheold provide as moot,~as possible ohoed dte eshiecs peoertoaoee.p005ider,ormwtie,: eves ‘on fields that am tsee reqa,!red The i001osimof*ds’rdiuoonahaultclpsloeesteetheaceomer ideolilt001ioeofthe sebjoetofthe rostott

tdieol,ierettroneaele. is ltntaee,.

?lseHlrutasepaslsthatachtopeoisrmolycecicss dsontoedamosydatooekisftrerpos]ngpessitieese,s,previden nodnsppliet,aatdteoeeeoselraatarolleetosis itfonroffen ferrrrisposulhd000bjecl BEFOREthere seaman to filet report Atepott eamrot he ted If tequred mfrnnat,on ,sstesem~lnn,rnmrhov tdoosoiftal Setsi~

fan rn~’ repels isfsseees&t au the ‘astor p’aeiitionos, provider, or sapptiea the repastisse nstby roastoube,ieoVojdofthe ietcre,eet repon,thro submive nei”report loothevocrrcesebject

FaillIro Co RepII’L

Federal.~ Stile r,nvens,e.ise Aeeneien

115*16 detnnslnes theas Couveneotee sperry has sebslaetidly failed or ‘spats itrrmomie,t na neeetdarrnsuith Sorties I l2t~ the noose rf the eer,tv wilt hejtabtished.

lIce lb Olsen

Anytsatthplamthat failslotopotticfssnisa0000oanodversraelioeo, tLeredtolte tv7mfledtothelilt°flRwitl be so5~ers so 0 nyu mean, penalty clog 10525.000 for each ss~l advetse Idiot not ttestted.

Qttraliosto aent] Ansssers

I. V,’l,ae infonnolionmil my oematokeatitn Ito required to report If ‘rennet IIIPDB moadaledflpnner?

This htfetanodoa coin be foosd in the HOPDII eeos]atisns, sod deperels oponthe time of fetal odssssenotions soar orgaeir,stint ethos aotisst health cone pasethiarents providers. ondaopptiere,

2. Wlnenositi oty organization he reqillred to 5mm reporting if’sroreo Hlt’Dtl niatda cr4

tototdnled Hlt°OB reponen lease eel obligation to rvsaoet all final adverse tetions tpainss lteatdt corepsetitiosees, prlavidrss, and sspptioi entoea nit or after Aoerao 21, 199b. This 5 lIsa date the of

February 2100 re-I)

NPDB-aIIPflB SIThS5TEt WWW2’l’liltO’IIIPDR,COtel It REPORTS

ptsbotioec When a rows ots~’ a Board’s oedea this action mess niso be tornatted ass RonisiasnoActeorn

It,. Whet reporting a eepriotatd hy 0 Stale Licensing Board, sshal Length of hello,, olseeld beotters,! an the repeal fonts?

The laadelnite selgelioe (fetarrla rede”99”l ethoold neircied as d,e apyrrptiate span sosees in the1Q05 fartessrfrnatdttrponiedrotheljtPori.

Reporting Erel,rcl,ann,e or Dcllore,e,,to

It . After an esrtosint prrind is norm ond Iho prartleloner is reieslnte’d, ‘0 sIte initial esetouuonropnro voided?

tess. The HIPl)Il ,euiss soposos of fetus] adverse meteors poats,sessdv, or saul they are ostreetedoraside,! hr the ‘openIng ete,tv no a do dirsotes,a ofthe Seeotlaey of lii IS.

02. It dacron m’ttiosnm peeled n resrbnoton lime roe on rscbtsiot lobe er~nemeahle?

No. My n,nrsnn ofesrlosiet tote is teponablr.

Repssoniang Ceiaeieoni rot ricegass

03. Iran istdis’atnnl ‘a eotsirl,sl am health rore-celaled nltaesr. does the3l ,lnvslnrrpsrt Itegitashen the ,‘edividnnl is ennvieeed um sshet lIt, lodividnal is setleneed?

The repast anne be ssthmiosed ssithtn an ealendrm ds~s of the date that the subject iseeesieted.

Ii. isaotelrrreol ennsieoinn still espnrtable sohen the prnbstisnarv perIod of the deferredis sneressallly rnsnptetesl?

Vets iThea the rrpeetisgagensev is assure of the dothotod ronsiosios, the spouts Into ho sohuninedsablob, 35 ralrssehnr Oats re the re,! of dte missthly reponing cycle. sshimheter ‘Inlet, The ft onshed,! he sahen,tled before the probaniematy gerard 5 compleleth toot ospodnsg ‘50050 dqsnX~sLupon Use sn,crcssfnI eooaplrline erthe pmobassest.

Reponietg IstJnorniosta

to, Iran injonetion is placed eta sapplier, hot thesnjtpt’srr1daus It appeal ll,eareintt. Urea theeappllrratill gel reported?

Yes, If, alien Use appeal. she iejonetien is tiled, a Revision to Arnie, mast be filed.

Repoetthop OtiterAdjoslirared Arttoso or Deniainan

16. isIs nrgaoia’,otints, as Hislo, eeeonlby berttniaobed a physician. It stem’ like It,is action isrefososableto hnth the 1fl15D0 and tb,r eel’DB, lItre do I repofl this artist?

If the Ithvsles’ao’s tcrm’aadvos’oas considered a professions] revisor aedan that resulted in therevoration of the plo~sic’as’s elininsl pniosleges, the anita is e,’posahle Ia dee NPDR. If theptleasieinn’serrrnmattconss,as csmidereot another t4ethroted action mid resndtrd an the ternttaleanof die p1 -sieitn’a ooeouan sohis Use lIMO to pearidr hraltlt mare services, it is repotsable ass theblIpOthiftiso tOMB santa dir physicimos el’,niral peivle gnat,! lerrnip,atesltisrntsoot. Use tots)

Fehn.an’ 2101 0-14 February 1000 0-IS

NPOB411pDB W000ITE0 w°nnv.Nraan.aIlpoacoM 0. REPORTS

moo Tcauess the adoose ctitical roiwleges action lathe ST010 and die coeaacl tatahoalira Ia theHIPOB.

Reporting Noise Cer,oendncolb’o Caeoan Plea

I’. Inn plea uiiuilrcll,esameasa plea uf°000larssoeeedere°?

Yes, as far as the tepoasbilicv of doe action is annotated, hassevera plea ofcolors’oee”drreeiayoat be eassidered as as, admission ofeiclo br art) otherpuapooc

Repoaib,g CCitt Jndgnaeois

II. A pe.eeilioraer is guilty of ‘radical 000lpnrlirc and saBles mlii, he plainlilt Isreportable?

No. The Hll°DB does toot collrcu infoneslion or ordinal anal settee papered’s Hasseow idlegeaclilisooc “as subsaquauiyulebaned boom a Federal or Seer ~s1th cane peogasea aoaeeeall of themedical matpmcrire, the debamseul snould b.c repeatable ‘0 the HJPDB.

Febnusey 2000 0-06

NPO0-HIPOB Ys’EBSITEt ‘flvb’°.NPOE-mP00.C0M F. DISPUTES

theesseepottaees’sswasmlssilllflseuobcssbmillgdlothelOpDorefeeeuringthrpocto,~tQeaanINsasber ODCN) of the none ueport

Sulsieei flisnultl

line sabjceo of an.4,trrese Atoms Rqsorl or.laetgioea,t roe Cs,e,lctio,, Report contained ii, tire HJP000may dispote either the factual accraaacsofa report or mhesbera lrpst 5025 sa,beoilrd is accordance snubdo HIPDB°i repanuine roquirmeesis, including the eligibility ebdo catina oepoa die iuaarssatias to theHIPOB. A su*ctreav non disposeareroad is ardor Ia appeal the urderlairg reasons loran adscosetonsiL

If a subject believes that isis~anottou illu ‘eport is facam]ly haec,caoc (fur hsstaave, an incorrect aiotmeaction cede onjodgmrne dale) or should tot tiara been reported (fee i,aslasee, a saspcosicsun or ceiusirslcouvirdas ‘ml related to haddi care). nba subject taunt anemIa ID macIsa the dbassrcttngoc dfrucllysvftbsdue repadiergenrier. Clraeges uu the report may tuesobmilled oulybyulrereparolsg culity,

~The,u the IBPOB processes a dispute, rroaif,aatiao oit),e dispute is,em In all qsedem ustro received therepast snithma the peso3 )mes, mid esill lie inrtndcd sdm the report soles, it is released 00 fatuue querieas.

A dispose is pus afthe specilic report far sslaicls it in filed. lfths, report in charged Ity the repadiogopsit),ilacdisunoaniaauuochdbstheerqootsaisessillberessovedlfthoschjreohebgsmdporsnver,of the repoa is featrally macaeate, the sssbjccemsstieitialg aue.sdLsputeafthcclsartgcd Epoit

ecrelarial Review

lfdaereposingcndosdeetiaes Ia cbaoga the dispssiedAothv’rseAcoiao PopuP-u url,,dgrere,,u urcaur,rnisoRquonorrakesaoucdowabeaubjecomayreqs,esolhau,be SteectsayalfllOlseevissvdtedispiagdrepsxtThe Seceeor~ mill er’s-ira d’apooed report eu~c fee accuracy effaccol isfetmalior arid 00 ensure that theisfunaaalirn ssss required m be eroded.

lire Secreeanmill sot unless,

list eseaia of ueir.tl jstdamcne cie aisoisal cosaicrioss.

The apyooptiateo,esu af, or basis foe 0 health plan’s adjudicated echos ev a &versaaaerat ageac~s orState Licensing Brand’s ,dretsractiuu.

Ta reqaeothercvicsvefadispotedrepertbythesevretarvthesubjeclmuslt%omdre’smtlotluepjpflmthe Secretarial Resiess request page leached 00 aloe Reporu Reu-isnd P°niotod, or Crests Cheeoycod

NPLaB4IIIOB WEIOSITE: WVW.NPDB.IIIPDB.COht P. DOSPSIrES

l°lae Dioprilo Process

i1,e HW05 is cuosseiaoi to nraintohise accleate inlomeatbtu and ensrnisr Oral beatda mae pmuddm’ecs.providers, and s’q’plieeo ace inirreand mheas adverse actions ate reported. What tht HIPDB rereism areport the isbosusticu isprocemed by the IlIPOB cemputer ssccm e,cacolv as ssberbned be the reporrisugcoils’s Rercdiereoddm ace respossalbis fee do ‘awfuL’s ef the isrom,atioa dtey report las ire HIPOB.

WlteathelllPflflpoocecsesurconio.asrpran Vrrifiusaeies,Davumemis ptosidedlaoheteponlisgeudrs,and aA’ato’lcoeean afar Regent-u men the 1)05° Beast(s) is semIs the oubject The ocbsjoaslto,ddmssiescthereport fur accurate, irsclndiolos such iut’eoaauoien n’s esaeeora addeco, tr,lcashseo essahcr, and place ofrmployerrott Subjeelsesaynocsslamilelrauges to reports. lfuayhrdbesrstisu, iou Icpori is i,taceu,ase,Otenaijeco mast eoeraeL the reposise entity or request tAils file a Cconccsianlerhereasere. ‘floe IIIPOBis1xol,ibinoi by law ftvosa e’oiifyisg islvssaadea sulresaed us repeese

lithe oepasth,g metits dtclho to chauge the report. doe ,cbjcecmav ieiliaseadispotri’fthe erpoonoh,oaehthe HIFOB dispose peaeess. add a slstemesot Ia the report or boot, The distaste process iseocarassarselapolestujsidpaesa or In appeal the uadeel>ing reasons of aer atherseactian alfccth,e she subject’s licensencmoebusisnisaiederalorslaiehealthcaaeptegemrs Naitherthomeaitsofactimisalorcis-ilesiterrtheappoopeiateoema( or basis form, adverse action ma’s be dispsisd

Sahjecoomlsddoeoadilasmtmtloadsacdisptsethafaeoslarrumcyofareponsheoldfollowthebusisactieus oa iso ,Vurifieaele,,, solo Reparesorehe Eases Sauas*I’aa. St,bjecn ‘aba da nal Irare the ariginat;Vaa(loeuoim, afro Report I,, aloe Dart, BooS(s) ‘lay thesis a S,,boeee Staeemeoa anal Disposer fnieiaatantheta fear, ire NPDB’HIPOB ssebsioe.

ilsesehjrchafarepolumavaddrata,.Juroo,aaeeportata,tyohnewheulbenlpolspmeesseoaabumcattmtificatioeofthesotoueiisscnltunilqserimsmiastrecivrdthcrrpodssudd,,thepeaoi,eeesand ss,il be iucludod ssitlu due r to ban, it is nekased to As,ore querirrs

Suhjecl Staumeeols are li,sitedto2,O00cbaoac,ers, iooeladi,g spacgsmdpe,,etoatirso. Subject Slaueurrenlsmnoiinninelnde any paiie’uroamm. D,aftia055t310asoyauisaccooshamcemiththecharacteeliassils

dane the soterreot mill castles die isfornastis asab~cct deems moat important All clrarsetersbe.aod 2,1100 soill use be arcepoed,

A Subject Stalemenr to part of the spccif,e report foesnitici, ills filed. If the report is changed bs- therepsrlisgeeliov, doe eaia,ceol ullsclocd lathe reportalsawillbc roroecesl, Ira saleasledt isn,eeded mitt,

Februan’2000 F-I

NPDB.0ilPBln WEBSITE, WWW,NPD0-HIPDItCOM F,fl)SPs,rf ES

The subbed also musts

alalcclodymdMe~sside~stad,fartoaeiadisandsshohd,rsuhjeetbeloiesmethefncL’s

Satasdi deeemcelattra esbstacsiatieg that the tepoottog eoits°s iufamoaoies is iaaccraste,Doctsmestotiocr mast dieeeiy relate tothe facts is dispute and sass srabosntsnllr ro,oasibt,te ID adeoermisuienofthrEeauulaecuracvofdreecpo,t Dscumesla&earsavreocreeed lflpages.iaclaEtagaeavlm,ects tad risbihits.

Submit p’oaof,ho, the sabjcrtaocmpord laresolor the disaereoasrena ssudr the repeeringeadts;hatsvascesucccssfsl. Poeofrnay be a cop’s oftho oi,bircfs cersesroedeece so the reporting codey and itoesdrs’s empouae. if

The seliject of the report slme)d wail for 30 dais them the daleefioidaousgdi,csspoiestsssud, dsrrercsetiagcothybefare requrodne Secrtlaoiei Rrsiav ef the disputed repow~ to allow ‘lie repodis) messy loose norespond tea dispute.

Pertimeort Docrionenla lion

lfthrdispnle relates ‘0 as A,tsu’rse .leeiae Report, peatlisere decssteescsiss mield include a cops uS

The indiogs of fad end meormsoeadaeiasta uf the isslth pinto er Slate licensing Itoardi

list baoalreportofthelrmoispp,oeloeethrrrqspehlate bm&apssssltich drcdeta,uipuioo ofthraetsero,eiasieasssas based.

lfdm dispose relates so ajaatg,neaseor Ca,rricroos Report. pasiocsotdrcuoeeuladru miolot iueladra estpyof:

Ills, ceausjndgasmtt

The inja000Ioo lOOeuesoll.

Iftteeesssey.th Secretlu,’ ssd ask them eg reality to supydy adebiotni hsfrsnsmiosoesafuassitgdotdteecpoflssassubsoieed isaccorot,otossith HIPI3B regslauiotse Eesemluoalnespoodtoassa1u,eso formareb,iaseuadc, Seers dee Seerclsry within IS dan After rrviessisg all doeumueotatia, rrlaled lathe dispose.

dccooems reisred so the disputed report. Please sole deal the dispole and any ureamposyisgdecrroeeaadcomsm be saul 00 due HIPDI3,tie diteculy lathe aeeeelcuy.

February 200t F-, February 2000 F’3 -

NPOIt-Hll’DB WEIJSITE: ~VWW3eiPDB.HtPt)BCOM F. ~1PUT ES

the Sece’rtusey ssit detemihee whethcs die~ infaeaatioi in thu disputed rerore is cccseaee mud sleeeald havebeen reported a the 1-tiPeela.

Secretarial Review Results

When the IIPDO ercetse.s pmpec notice era request far Secretarial Renview. Ott neolenialo exit befenvacded en the Secretes ol DHHS for review. mete are dree possible osteasors for Secreisela]Resins of n dEepest:

- list Secrdaey coeretudns titan dee tejart is accoralc.

- rite Secn.sae~- concludes that ntte repro isiasecuate.

- The Seceebty roncleden — the isuono in dispute are eoside the scope of Secreodil Rebiecy

kntnostAeeerateae Snheetttret

If tine Seceetoty esteeladea that the heforteaeioee in tire report is acetone, e~e Secnetety “ill wed netexplanation ofehe decision to the ‘abject pr.tcnitiorer, pnooS~er,oe sopplier. me eohjncttoas thee oobteil,ultin300avaaxaeemesttieaaeoiltbeoddedlndeerepoet Theealemneistimieedae2~aOnebaacwrsiecbeding spaces nod ponctaorinn. and “UI be eoteeed into the HIPOB computer s~seret exactly asealseinol The new Snirjeca Statenteat “ill trpbce any slatexarot the utebjeca enbaciesi peeviansty.

The subject ofltte repses, the etrpeteittgroiiee-, and atl qncriees who received notice ofttee diepuied repenttsitlinthepaea 3reeatsesiltreeeivoaRepoereReriaeef Vnlrteetl orsnoetasChoaegeddeetaiseetcenaisiagthe Secrrtmys txptanaueaaed the subject’s untenene. fnesre querietiesilt eecerre thesuhjcct’s seatereentdade the repotn.

R,mttrt Ementrate me cabenietee’

tfthe Secrecies cctetenjesthatthe eepottin in’cceaaetthe Secretaevssill direct the lilPfltotacoacelderisfomeaffonin tee rrpott The setbjeci of the opens, the eepooieg entity, ned all qnetiero’rlta receivednotice cftlee disputed repoto “ithis the pest i )waes cit rcccsiveaolcprrre Renlaed. Voideti or SenecaClwetgeddeeaaesent amusing jean nfttte connection,

If the Secretary concludes dma the tepcetssas,nbetierd in emir, the Srctelaey wilt dined that the eepnnhessaitlant feurn the firm. The snbject efdeetepoes, One tepooting neiw and nllqnederswhorcceivedteneireefthn dsiteteud eepoet within the past) yeses sniti cede-s a Rejxsn-e Re’t*eni. Voided. are Settee’sChanged decetneree ianfaetnhig Octet deal dee eepe.we has teen voided.

Fobessany 2ttO f—I

Pipon-UtrOm WEBSITE; s,VWxV.NraatltpOlLcOM F. DISPUTES

Fxam tin of O’mnett cc

Dee t’rsreen - Atlesod nested

Exntnpte: Apacddanerallegedthaeat,etdtplaatjeairnthimdnepeoceeeansettsetseajthpianienaeddtrteeicecna nfmedcai espeds nrothrrseiaeasen catted to prose saaitaspoine the paaedtineter felt esereiegweeatee en the derenne.

Outcome; The Seceeuey determIned thlthedispmeneqaestssaseeajdetheseopeofresiewaanteiadenaentcs’tothatelfectieetheeepos. Thrdispstecotatlaesssanrenneedtoemtherepeet

Narrative flcsreiealnr-traeewate

Example; A eupptierdispeaeed a report ofa licenettediwiplinan’ action eakne tea Sxeelceesingaeeeneastanetg tine tine oaeeaeine resenting the act soasinaccteale. The seaprelico ecqetested thnt the dencritutonhemooed In reflect the findhs,seftheceenes.

Ottceetnee EheSecwteytn,ieeia) thenaeaeiveagahescthc fmdingseswtnoiby One tiueeehsgcgercs’asddaeemtjcrud thai the eyed snnntd be aectrale tithe area) laegaage from the ugenc~s teeing’ mete everd.lien Seceder’ eliteceeai the HIPDB a change nec naenatisa The dispcea eseatisot was removed risen dteye ye et

I enenma ~‘oheesey Seaent~

Example: ,~exnesr dispeecd a report thin she bed sneneterieeed her ticeme. The eeesedispereeei the reportentIre has’s nbc site lead sttrenderest due to gernoetat reasons. tntetteed en her peaceice. The cease steeddeueaheslretetidoed her license hecanse cite wan noosing to another States

Seerctaryee Rcepneee: The Secteecee requested Out dee Seate liceneleg board snbseitcenseeenpeoeteoss doormeeelalire sicoscion thee dte ennsons for the ameendee “era nut nsa reside of thetense eleapty ceesendering her licatne to nave to arrcrthec Stair, lire State ticensing stbminnddxtcseeaenlieet nslticle nitcesced Pal the tease esas renter insratigaeiete far paliene abuse and lead ascent tothostnuen&rhetioiofheiinernuxeiptheaes retiree. TheSrcretaeydreecenitaedthaldecacoienssasrepooableacdntadeanexylathuteefthceintherepaetmod’npueenouniooseaaremasedfioatdrtepott

NPDB-IItPOBWEttS5TEe bVWs,V.NpDB.ldateaaco,r, F. fllSFfltS

O inn n Ir 0. to’ t Inc Sense ti See rat eta I Re. iesr

tithe Secreeay ccecltdas dan thc cane ‘as diepele is causide the scope of redesv the Secretary will direstthettPraftoaddaaeeenrathe.eciircn:nthrqmnaedtorentavetteedk1njenrutaais,ufnsmflrgwpeesThe subject maythen sehrue.ssathrn 30 dave. a enulanteaut that soil he added a the sep00. The statementis tieeeited no 2.000 cbn,acerrs, including spneex and potecteation. and mitt be eeorred into the HtPDBceeapeaer sflteeue eaartly us snhrniied.

The xrbjecrnftteeectxeet. the tepodietu conies, and all qaeniens otto received etatice of the dispated reports’ithiethepeayenonnstteceiseratepasea Revdaeeri Voided oo-SoeaiecoCioa.egeddooemeretinfraeeherthrees of dee Sgeeeunicdccisiee.

Recoensidorailot. of cite Secretary’s Decisions on Disptr ecu

Although DOORS Ores cot bce a faneal appeals pnecer for reransideotias rfthrSeeremryideeisiaesoedispcigs. DH]Isesillenicwssch ecque.t The snthjeeepsctinancr,peouideyorcqsplie,moscsabuieassniecee request for recoeaidcraeiae en tie office time issued lee Secec’lary’sdcneceusiealioa. The eshjecteicndd bt.ejsndlltealsimnrnrennvthfonnaeiendmtssasurox-±bhleaedeethneofsncecnaeial Rmieseendirrwhich canes the subject brl’cses “eec net apprvpoiaeniv considered detebug the resiese precesa. TheSecreens “00 either clbJeas dee geicxddtaunileadre an issue a rosined fodio~ 014115 wilL heevevea givepriority to initial retluetLo for Secretarial Resins.

Improper Requests for Secretarial Review

A reqeenc fee Seaetaeiat Restiesv ii crnsidceed itspecneer ‘sloe the report in qeestinn ban tat peusiocelvbeen diopoted h Ow snbjecn pnaedliorrr. provider, or supplier. Before e’eqtrslisg Secretariat Reviese astbjees metes

- First, aaeenpc to resetse the disageeeeeeetwidt titu ecprenittg entity.

- Seeoed,disptanetherepoenaeceestiteitodeeinseuciaaxprarideejondte Neeiftcaniote ofa Repornie;the Daae Breni(ea doeeraenL

ft subject sthtteiea en iuepreper eeo~ara rae Secretariat Reviets’ the ttlltfll will notify dee atebjectfearthirner provider, or supplier deal aesotatirn eith the repoofre entity nest he eieeeaaperd fetaL

Pohrnan 2ttO F-S

i’iPDhI-HIPtIB WEIeSITE; WWW.NPOISilttDmCOM P. DtSPflTh

Ceineieul Cmene**o

Example; A pearielco disprelai a report nra health cure-related oimiml coeesictiae. lit: pnosidrraeeeedthat hewss- never ceenuictcd of a alone. The gsosider nrrued lee had pleaded cleric reareleardr’ec to ateaiegette’n of uabeatttiee feler elKoess en a health pbrn and thin did roe crnulthce nointhusi eaur’ctireu.

Seereearyts flee ponte.ThrSroretaayectedthiseo.saeepcsoableerrethasednederdeeeeitJonafaim’aetlceesicetooae referenced in the Hlt~us nepatanicess. The defchias of eeitaiaal eceosi,eioa hecta&aeeelaeeaieoeaelcrc planers a cehulneal etoeeeieuen. lice diepsete rotctlon tens removed rennet tier tepee

QuesOionn and Antsdlera

t. laces rhersectenrofnersetfc’,eteaec. I nrreivod neeritieatteao nra rrpnre ‘bone her it theIHPDB. Cent I dispnte the report?

Var, in dtslinetea eepoet lea yew esifeir batsaif, vote retest preside deaeneeeaealire bat yot bare box,appateted tee executer or teal eeptvscstaeise of her estate. Acceptable docemeteiatiaa can bephuccop’) ofteeetstlt areoher tegal &cnrnwceatioa atcassieg vie as the csecteot;iegat evprcnextaiine.

2. When a utbjec ealloultel, en rasolreadinagreenerness-itle a rqenrtingettiIy~ rotten the disputebe emote-ed witle tnarrreein time frame?

No. Asuwecareinna inject drmpaoingmthr.iteexOehut~offrsihjex’odimgertnentssiththerrg00rand tieebasisferthaedimgreonots,baethrcetsemeeqtdrernestootthednpueemustber~nredssithioa cceuaie aeaeeaee oftime,

3. Ira sreltjeclaishes en diapttr a repten. dno the inlsjcrO has-c Iaenbeesit aaeatrnncnt at th, timeref eliopente?

Ne-The ethjeccota,e. yeses-ide aslrteens:ere oxide the mien ice oftlispec, but to tot roqtieed to do so.A Subject Seatentenc may tea stbmiltoi at any deane.

.1. M.nsca subject initiates d’tsptte in order en add aalateeen ‘too reptrn?

No. Tier subject cia report any add a staecmcnt too eyed independently ofthr dispute pteeeou.

5, areaeosecrota.y natea I diepale lobe hooted eheeenpeofres-ietva.e d ptncesa.eo lotion to thintWeet In tee HIPDB, eattasutejroi alto acid a uratenaree?

Febneaac 2000 F.6 Febntary 2110 P.7

NPI)B-HIPDB WEIJSITE; WWW.NPDB-HIPI)B.COM F. rnSPITES

Yes. SubjectnsiII besotificd oTU’is *~“ by lie SecreiJo, Asubjeec Siaiemern njdej to the rq~ottafter dbpule cr.’olation c,0l reybes any rojor Subject SlaienienL

Pcbntaer 2000 V’S

the DataBanksNsisnnul Proctitioner F Hcdehcunc inregrily is Prorncdon

wyno isbasi.

Residents sod ollenss D-3Professional Secictl 0-3StateLicrssiaglsnsnls 0-3

TvposolQueries 0-5Anontey Access 0-sAuthorized Agents 0-6SubmitiingnQuervno the NPDB 0-6

Equipment Needed to Query EIrcIuoaricsIl)- 0.7Querying Through uni Atslrori,ed A

QueryPmcessbsg 0-7Subject InformsSubject Osnzhssg o-gChaructertimils asQreuvRcsponscs D.8Query Rosponso Availability 0-9Missing Q~~Y Resintsen 0-9

Correcting Qsosy Inform 0-9Failure to Query 0-9QoestioosnndAnswgss 0-Its

9- ReportsOven

tsnseFrnmefnrSepooingiothelspos 9-ICivil Liability Protection 9-IOfficio! l.osgiioge 9-ICompttaliors of Tinie Fern 9-I

Submising Reports no the NPDO _ 8-2Sssbjeullnfoemution, E-2\~Thea Subject infonorstion Is Octal 9-2Reponihig Sobjoce Social Security Nsrntbeus 8.3Incorreclly Identified Subject 9.3Submitting Reports Via the QRS 1-3

OrufrCupsbhlt 9-4Ssbueilniug Reports In nIneNPOB ‘9u ITP .13-4

TMsen of Reports 9.4lnsitiulReport 9-4Correction asVoid Previous Report asRnvioien Is Action as

Report Processing 9-6ReportResposncs

Missing Repent Vgriuicotion 9-7Reporting Medical Malpractice Payments E-i

Trigger Dote fur Reporting 9-IInterpretation ofMedizol 7r olpeorni cc Payment Inlbessnalists atSample Desenipliuttu (for llluswslise Putposes Only) E-9

N5~t)tCrai.Isbs4 tasiL-ccCrssesoe

A. InlroduenionPatinae..Background A-I

Title lVofPoblir Laos 94-660 A-2Civil Lisbitity Pentsetion, 4-2lutrrpsvlotion of NPDII lnfnntnonsCoalideutislity 011<10013 Inform A-3Disclosure ofNPDR lnfercnnti A—SCoordination Between nbc NPDB nod Use IIIPOB A-6OllicialLonguo9 4-6User Fees A-6

B. Eligible EntitiesWbolisaasEligibteptrlit B-I

Defining Health Cure C 0-2Hospitals 0-2Other Hesinli Com Enni 9-2

Dnftcisg Pesfrssionol Societies n-aDefining Staterticeosing Boards 0-3Defining Medical hulpeoceire Povern 0-I

ReginteeirgnsidtthelsPoo 13-4CeotifyinsgOlr

Entity Recensifsenti n-sDunn Sink Idenlifirotinni Nstmbeus (00105) _ 0-5

Denctivare 0 01310 B-SReoctivsxeo Oslo 0-6

Uneelos [1-6Updule Entity lslornsotion- 13-6Lost fete 03103 0-6

~ Tltsl Msy Report usd Query on BrhatfofEssts 0-6.4othorisesi Subnai 07Alalhorized A 5-7Designaline Autitreized Agents B-SQuesnirnn and Answers B~9

C. Health Care PnigtitinnenOsersiew c-IDetiningllenllhCorepraclitionern C-IProositiemr Sell-Qeery c-4SeIt-Qsetyingesn nbc Intomel C-4Stbjecr Infonsotion in the <PUB C.4Questions rod MIss-gas C.S

0. QueriesObeevie U

Hospito 0-I

Sosncsnnsssort

i000ainsusk taktrucrsssoea

Reposing of Poylnesls b3- Isdiciduols 9-IPoyoscnu foe Conpertlieostsdllospiu 9-ItDeeeosedpncniti Eliideatifrisg Practitioners 9-I IInrassesere Policies that Corer Morethsrn One Pencils F_IlOne Selilement for More thou Doe Prorti E—l IResidents sod Iniems E-t IStud E-12PaorlitioeerpecRnfunds 9-12LessAdjttsonestaxue 9-12Oisorinol of a Defendant rromo Losssstt 5-12High-Low Agreements..- 9-13RepottingbyAtthesizedAemts 9-14Payments by~Itlnipie Posers 9-14Stuornored Settlements 9.14Snbcogotios-Type Ptymrnis 9.15OrniPoenrenis Made Prior to SriOgmcn L 9-I

Repoenitge4dveesg Clinical Privileges Ac 13-I?Multiple Adsense Actions, li-ISDenial ulApplicotirns E.l49idsduswal ofApphicari 9-19Inreshigations fl-I)

Guidelines for ttsreodgoOont 9-I)Summary Ssspetsios 9-19Diomples efRepornable nod i~los-Repoaiubte Ant — E-2 I

Reporting AdvecseLiccstureArnions E-24Efftcnive Dote ofAgrios 5-24Examples of Reportable Actions 9-24flxanspton efNon-Repoaiable Arti 9-25

Repctiisg Ad’eoe Peofessiooah Society Membership Actiens 9-26Reporting Rrqoseemecls 9-26

Rrponing Mgdieaaathngdhcoid Exclusions 9-27Sanctions lot Failing ho Repent to dte 1<15DB 9—27

Medical Maiptarlire Puyers 0-27Ftonpilols rod Other itenlih Core Ennin 8-28Shalenrords 9-20ProfesaionolSnrinli EatQuestions and Answers 9-29

F. DisputesThe Dispute Proc F-I

Ssbjeot Statements F-IStbject Oispmes F-2

Sectetariol Beviem F-3Pertinent Droomeololi

Scsisnnhrrlsslsnrscstes 21501

5.bln necustes, Susan C,sijcbnst.

SecnetardalRevieivRenslesF.~ReportAccueate as Submitted p.4RepnetnnnccunaleasSubminedr.aDispute Outside Itt Scope of S~crc~r~I Rnsiess . F—S

Secreenrial Review Orervioss F_cRecrnsideratinn ofthe Secnetra~’s l)tcistrenv on De V.6]mprnpecRoqaevns for Secretariat Review F-S

EsnnnpteselDispntes, V-6Due Prncoss -Allened 0 6Due Process - l.egal Action Pending F-liLiceiesaie Completion - Thgget Date- F-7Nacralire Dcscripiioa- lnaccurnee F-INartatire Doscripniesn-LrgaI Sufficiency F-INunnneive Desceipiioir . Misleading F-SPeivileces. Renignstian and Surrender ~Vleilo Under Innestigati P4Psiniterne . Ssapciunicsn and Hospital Monk-all p.9Profesuisenni Revires--Aleennauire Employment Teeminnuion Procedure P.9Residency Sta p-pResponsibility forTreuuncnn F-PSelulennent - Subject Disacecen p.10Settlement- Subject Dismissed from I F-InSsupennioit- Indefinite Lenigth F-toSuspension- Sunmnauy F-IDQuesniarn and Ariss’,ees F-Il

0. FeesQuervFees 0.1

Entity Qaeiy V 0~Self-Qsaeu~ Fees 0-I

Melinda of Pasnv 0.4Account Dincrepane 0-3CeedilenndDebins 0-4Sankrnp 04QneslloosnndAnswers 0-4

IT. erulurinanion S,,nrresNPDB-IIIPDB tYola Site Aasistancc.. H-INPDB-HIPDII Castornser Serrico Center ... Il-IDana Bank Addrnsoes.... H-2Ieterpresatjun ofNPDB Slaisten and Reeulali H-2The Privacy Act and the NPDB 11-2Tile Frecdean uflnfnmuunien Act and the NPDD H-]Federal Employee I dcenuifncaniunNnunber H-]Stile li!odteat and DenIal Boards 11-3

tntiunho, 2001

1.001 cashbook

A pPuno DIX As OtossarvAPPENDIX Os Laws and RegetatiocuAPPENDIX Cs Abboesiations

toOl, so Curicen

Ssrsecbar 2001!

srnucsWricab tl.rsrcAlsealsaaao

Preface opened in September 990. Thiucompedietsive Gssjdcbnsk is far both nesr

Tb eXureiaaal Pn-oace,ennseer datun Bank nod experienced elllities deal are eligible noGn/unebosnk is nreanrn Ia acne as a eesennce pnni ripate in the NPDB1 il supersedes nilfor the usees ofulte Natiunnl Pruelil loner preeiotsvetsinsnse -

Dana Bank gNPDB). I civ one of auumbcrafelfurusnu iuuubrrtu lie Unined States Backgroundlaeatltr care connensunity nbout else NFDBaasdsvkstiuncquircd Is romply evidi the The teciulnuinn nltnu led 0 die ercanion ofrequirensenls cteabtisbed bvTiole IV of theNFi) Resasesseted because hue U-S.Public Lnsv 99.690 kr Health Care Cuageeni perreived I Iran line ilirreasingQao!iej- Incnn-auonnrnn afro af 1986. as occnineaerafeuedicat eratpracuiceamended. This Guidebook mutaicu lisigneisin and die nerd to tinpro’~ ulietslbemauan Ibm authrn ized usrrs need Ia qualit’ afmedi cal enre tad becomeinterucl ‘than the NPDO. Auudtaoiaed users nalloawide pooh loins dm0 vssmmunledinclude SI nte hceasic0asnlsaeities; gneaterclforlu than those that could bemedical rnatpruceiee payers, hocpinals and undnnakcu by any individual State.other health ca re enruitim; cud pliysieiaus. Er entire profeusi soul peer review candenuists, nod athcrliccused heatuh cure mslsien cite abiliry ofiocempeleuslpraad linnera. pearetuioeeealo move from Slate 10 Stale

witkeol diselousre net dtscoven ofFinal regulantens govenaiuso lIne PrOD previra v damaeinr ur incounpelcunwere published in r!ue Feufceo! dlegiuiee on pccfoenoauce. The Con ness felt I luau dieOctober17. 989. and nut cssdilied al 10 Ilireauof priratennunL~ damupe liabilinyCPR Peal 60. The U.S. Dtpaetansent of under Pndcmt laws, iocllndinencebleIteulih asd Huanain Sen-ices 0114S) is dannuge linhiliiy nuder Fedeecl aauciunsdresponsible for implementine the NFDB. law, unreasunabty dincennaged physicians

and denuises from panicipaningiuelThcnireThis Guidebook is dirided into broad professional pecrrcniew. Therefore.topical seelincu. This mEnd anti on Cnneresn nnsghn to provi do incentive andcontains generul iufornraliun en the peruecuioc fur physicians and dentistsNPDB, which itneludcn inn histons,ui cIties eagacire in eltecuise puofessi coal peerand reesulationt lint govern it and uthee review.iitfoennaniaes for uutheriacd users. ChaplerII. Infoenualios Soueees. prnvi dtsavaeiety llratines were held in the U.S. House ofnfaaurcrs In facitita Ce uneriatemclion Represceuaui’.es an the proposedwith the P9DB. The Glossary, included legislation. the Healnil Cure Qusslio.as Appendis A, defines tenon tietpful in Jnqaorrenensa .4cc ol198d. on March l~undersl.’utdineNPDo opcnalinus, ned July IS. 906. by the Scbcommiuueemidst dice queryieg and repeating us HealIh and he finvieoeetent,requirements. Commie~ on fnerff and Commerce, and

oil Otlaher 8 and 9, 1986, ho theThis edilian efnhe :VPflB CrnI&bennk Sllbcemmittennn Civil nod Consninis~onalrellecla tnt rennire range ofNPDO policies Rights, Conanillee on nlno dudictant. Atand operalieuu, iuucludisg thave uhat hate there pnbticlneaeinns,tevuimonywas sirenchanged or espoorded since IhONFDB by physic inns, ctta’meys, insurance

Sepensirr1utol .0.1

5055 Gnu-bad,5 P0 5 soUr scab

officials. teprosesrtolivcs ofhealtlt caneassociations, and others, The Hro/IhCrwQuality ls”pross-aaaenlAel nf1956 wasIncorporated as lisle It’ into legislation

ronscairing Stairs to develop cnrahtsh, aridimpleonenn Stair comprehensive menialheatilt plans. This legitbcion becamePstslic Law 99-660 cvhens it stun signed byPresident Ronald Resnan onNovember 14, 906.

Tub IV of Pobtie Lass 99-660

The intent of lisle Vat’ Public Lass99-6610 is to improveihe qtalily of healthnate by encouraging Stale intoningboards, hospitals and other health careentities, and prafessirseal societies aidcati& acrid discipline thnsassho enragein naspeafessiosal betnasiaru and In restrictthe ability of inrampelesl physiciaos.dentists, and ocher health rare pistil lion—mto wave from State no Stalessithantdisclosure or diseoveny afpres-inmmedical matpmtiicr paymeoi and adverseaction tuislon’, A dsgcse actions caninvolve litetrssnre, elnnical privileges, andprofessional satiety ocemhoesunips.

0511 Liability Prolecilon

Toencoanage and support peafessiossalceviesv activity ofphysieians arid dentists.Past A oflitle lv peavidesthar theprnfessioitslreviesv bodies afhnsspinalsand other health care collies, mcd personssen’ius on or onhcnvise assiatiog suchboSon. are offered imstnoitv feats pnivalodaoages in civil salts under Federal orState law- ltnsnanity provit’tons applywhen prol’essional review responsibilitIesare candotted minis the reasonable beliefeffartheeieg the qnslilyofhealth care nodwith proper corned far doe pnnstess. Thereage exceptions andre he law foroisil

rights actions end osicitasast octions brot’glieby Federal and State Gavemments,

In order to receive immunity pranectian. aprofessional review action regarding thepeofvssional corepelenee yr prafessionalcnndnen ut’s physician or dentist asust henaken:

• lathe reusoenble helicfthtt the actionstasinilte fartherante sl’qtnality healthcant

• After a ecusnashln effania obtain thefacts of the violate,

• Afteradeqontgooticeandhearingpmvedaees roe afforded to ihephysician or demmsn involved araftersuch nihee ptocednees as are fair no thephynicias ordeslistsnder hecircotvntusces.

• In the reasonable beliefiltai lice atticsoarvnnted by the fncis knosse,

aftersochttasousblr effort to obtainfacts mcd after meeting the nolice andhearing reqtnitement

the imnnnnci ty provided hy theKetch/i Cane Quality /unprawasneos Ac, isfrom liability rather than ‘rain sum. adisciplined phasician ne dentist remiss heeight to toe’, hosvtvee,the court ma., nsvaedattorneys’ fees and court oasis In thedefendants lithe satin in deirmsined robefeivalnns, onreasnsable, williamfoundation. op in bad failh,

Tulle IV ufPublic l,aw 90660, the HealthCare Qttalitj’llnprorrme,azlce wn’d986,led In the otsablishmeat althvt’iPtJB, anisioemationclcasin ghannse, to called andrelease certain inlonintlian related latheprofessional competence and conduct ofplussicions, dentists, and, in some cases.

othet health cave peacticieneos. licecntablishmenl aithe NPIOB rcpmcents cutimportant step by the U.S. Coceoassstm tomisance professional review effaats bymcduingcnetsin iefonnationvnncerningrtedtcnl malpractice payelenin and adverserations available In elirible entities anditidividoals,

A web little the NPOB Recalalloascodified at 45 CBs Purl an is eefcven ted inAppendix alibis chahlebask,

Inlerpretalion afNPDBInformation

The NPDB is primarily art alert arflagging system. The iviornianioncontained in it is intended in directdiscreleinqinry into and sereiiayalupeciuic areas tcfupoacdtisner’s lieerrsare,pmlrssiaoal society mcmhcealsipa. medicaltnalpmctice payment Idatsey. and record ofclinical pdvileges. 24PDB infornsoiiaaisan intpeenant supplereeni isacomprehensive andcaeglolreviewal’apractitioner’s pcofensionul credentialsThe NPflm is intended to augment ndreplace, tradisiosal forms ofercdeotialsreciesv. As oetationsvide lagging 5.51cm,ii peavides another eesnarce to avsiit Stairlicensing bnaedn. hospitals, and otherhealth care entities in eandortingextensive, independent invesl’sgauiess ofthequalit’tcatioas afthc lsealnh carepvuctiiiasers they neck to license or hire,ov a whoos the’, ss’mh 10 giant clinicalprivileges,

Settlement of aieediral nialpisenice claimwig rccce faravurietv nferasostshaedavat necessarily reflect negatively on theprofessional campetente erenodocto fthephysician, dentist. or otltee health carepvnctitieitee- Titus, u payment made in

settlement nra meanimi malpracticesell an orvlaim shall unt be eonsteocd asa prascmplinn hot medical malpracticehon occurred.

The information in the Nt’D8 should acneanti’ to nIna Sns In liccnsiuttg sstherilies andhealth care ecnilieu that there may boaproblem ‘sith a pnrtictdur peaotitinstov’npro fevsioaal eamprlessee or conduct,NInDO inl’orcsaxinn shasld he considevedtogether sviala at her relevant data ittevalnalicg a practidacer’s credentialslc,g..evidencce ofcurrentccmpeteacrthracach coslinncss qnolity imptnsrssesstsludirs. peer recommendatsnes, healthstatus, verification ofteninisg acidetpeniencn, and relaliosssrips syith patiet.nsand callcngaes).

Confidentiality of NPDBIn form a Ida

tsfacesanion vepotled lathe NPDB isconsidered cssal’ndeclin I and shall oat bediscinsed except us specified in the NPDBregotatirml at 45 (‘PR Fans 60- licecatufidertial eeceipt, stnrsge. anddisclons,rofhtfomsmiact is on essentialingredient oINPO0 nrem ions Aermprehensih’esrearity cyeem has beesdesigeed no prevent vaaipnlstiaaofaadarrest no the data by tcnamlcovizrcl safforexternal minces. The faciliny in which theNPOoisbsnsednteelsHHsseccsnityspeeifccalions. sad l$POB snafflcavrtsrdergocseis’depth hsvkgrmscsd sreuarinyisresnigutions.

use Office oflespectoe General (DIG),HHS. ins bern delenated tbe anthothy toimpose civil money pesaltitsesthonesvlnovialnte the venfidentiality pmvisiasssiTitle IV. The civil money penalties forviolating the confidentiality pmv’ualotts of

A_a capseobazosm

ccapnt A tsmviscas sins oc,dubrk

Tale IV ors Ia he imprsedia the ssmr JncformalcoscAcr(FOIA), S USC 4552. asmatuseraunthrreicillmoncy penalties amended.poesnant ta 41 I28A alike Socialscrnarinyira, 42 U-S-C- ty2na-7s. Regnlmianu The coufidratiatiny provisions ofTitle IVcoverutitue civil mnney penalties under do oct prahi hit on eligible cetita’vecciving§1 20.4 nrc set Ionnh or ‘12 CFR Past 1001, iosfannation from the NPOIO In disclose

the iiicfnmcatina Ia others whn are pastorP or each viatu:itn ofeeafcdetstiality, a the prer reviess- pmcess. us lens m lievigil manty penally nfnp to SI 1.000 can isfeanationiyssed ire the paipnse orbe levied, In aiuo’ease in svhich his svh’jvltits’,as provided- franc pIes ofdetevreinenl thatmatn than one party was appropriate uses t2fNPOB infnnsnsatienresponsible for impvapeely disolosieg ieclnde:eanfud enliat in formation. u penalty of spto the snaximssl 511,000 limil con be e A hospital muy disulnse theimposed ngainst each responsible infoemntiao i receives fran ticeNPDBindividual, entity-, or rrgaeieatiau. In hospital officials respsmible foe

reviewing a prnetitianee’sopplicutionPccsens or estitivs “ho receive for ansedt’eol snaffvppoistnsenterinformation ‘ram the 1~5PDB either dire~ly elk leal privileges. Is thb case, bothor indirectly on ssbject to thr dcc haspital officials whe receive theconfidcetiatils’ provisiuni ond the infrsuoutiot aisd the hospital officialsirepositiencsfseigi I musey prnallvifanesc who suhseqtettnlyrevs’esv’tidug’otg bevinlate those provisions- When an eoploamenu process use ssbjecu to theauthorized u_cent is itcuignaled Ia handle cetfidentiality provisions oflitle IV.t4FOB queen’es, both the cntiey and thea gent ore required in maintlaro • A pn‘vale secredination estity cancoalideutinlily in accordance with Title tV revicsvcoii ltd ential infamiattnn thatarequirements, hcohli cage eotilv has ohtaiccd

regarding its practiti anets only if theThe Priu’ac,a-_lrt, 0 USC §552a, protects propose of the discbosore is to tansyihe controls or Fed real sysneinu afrecords sot peer revn’esv activity for thnt hrallhon indisidsain, lihe ilcnse coalained in the cure enlmtv (i.e.. the privuteNPD0. from disclosure ssitheut the aetneditari on eatiny ruaintlaicss o role inisds’vt‘dual’s consent, asless the diseiessre the derision-molting process faris fnrorotllne use oftise system of pruelitianerttaennborslnp in the healthrecords on poblivlted asannolly in she cart rosily, which wasid male itsFcdcrO!ReSlacer, The published rounise activities part ofthe peervevirsvmes afNh5DB information, which ore ptncess). tfthe private aeceeditanianbased Ott the laws and the regalnlians entity’s atlivilies are non consideredtinder which the NPD B operates, do nat paul of the peer review process, theallow’ disclosure no the general pablie. pcivute tcrrediiauion etitilv cannotThe litinined access provision of the Nra/c/i view any dacameuts that the hcottiuCorp Qnatnty’Intporacrment Arc aJ’1986, as caynt entity has obtained thom lieamended, supersedes thedisclosnnr NPO0 that shasv the truths ofaorequirements efthe F5’cednsm a! NPOB queny (re., match area

matclt). sods ns an NPDB report or the

A4 ieprrevheriml

vupemamaeot isa

Nnitliosidubeak Oapa,AlnIn,’dsa:lna

qrely respovsr dectumennentitigd, tltt NPO0 art pctnnined B vhste iliatReepaase to fsfacsenstia,i lOasrlosare inform none scinls sv homes or they choase.Reqerat Hossevee, die heslth careentity ssasld sat beinvialanioa alibi Dinriosare oINPDB gnrorntualtonconfidentiality ecqoireiseris if indiscl auesavapyofthe Rcs,so,tsc ro The Health Care Qirsoti4’lnnp,stcs-atenfAroJau[ec’asaiion Discsnsare Rc’qarsr eo the af)9&6, asamended, and its governingprivairaccredilatiosenijty, as long as reenlaumnnslian it the divolasateofinfarmadaa thnedisrleses the qoeny infarnsauien is theNPDB, lnfnnsseiss Isrcssliis restored from the cops, (i.e., ava liable to:so the dacxcmentshnses only the nnmesonss’ttich qoenies sonic sabmitncd). • Hnspitals re qarstine isssfaee,atiosAdditionally, ifti,e health cave entity coneerning a ptacniIioner en theirobtains o release freata phs,siciant medical staff urtusslines theyhuveanthorialile isis spccilicalty release eranled olisical pn’eilegcs, an vitlu -eoafsdentiol isfanmunins it ohaa’ms vcspntcl to prnfensn’naal evviesa’ activtty.from the 2/Plan is the peis’oteacrrediistionenlitv. the hetith care • Health care eetiti Cs (ineludleeentity may da is s’,ittmat violating the hospitals) that have mitered ernsay he2/FOIl ‘scott fidennial’nty res&ictiatss. ceteeing cmployrnenarraffihiatsan

relati onshi pssvitttapvscl ill onceThe dontidemialils. provisions do SOt ssi,irh the practitioner hns applied farapply a the original detriments er records clieicat privileges or appssmotmrnc Infram ashich thn reported infonumion is the medical stalZ orwmn It caged soobin’med. The NPDB ‘sroccfidcntiility piofessi‘anal 1ev’new octi’vily,pmvisioos do not impose my onweaslidentiality Inquireot rots orecvn ricliots • Proer,ninaen requesuinig inrorniudnaon thase dactteseens orecrards. Titus. ahoan themse byesthese caitfidvstialitv pros-tx‘ions do nat baror resitict lice releoso afthe underlying • Baards of medical etausinersor otterdoccmeets,ar the rnfonautsan Itselfn by State lieens hag boards.the entity tohing th eadveose acorn ormuting he poym eel insetllrrnrse 010 a Attoreecus or mdlvi daals reprcscating,vritlen medical isahptaence coarpiacsn or thumsclves upon snbmt’ssienefpeaafclaim, Paresamplr, fr hospital that Ihata haspiml failed Ins ‘alhmilrepo ned annd veoc scton againse a onindetnes qeney.ptcyst‘elan puruu our no the pravtuioss oflithe IV, receives a atcbpoeea far due • Persots or ensiti es rcqnesningsnderlyuag records, 1 mayant refnseis macformation isa form svhieh dote notprovide the requested dneaas eats vu the idcatilS’ nay partirslar entity’ orerounds that Title IV bans he release of psaclitinner.the records or iutfarnsannn.

. . The Pat-at Are pealed silie cnsteutu ofindividual heahheate puaettttsnersw Ito Ftdegol yysvetnts of recordsonin~iv’ideals,ehtnin untfonsnaoea ahootnhemvnlvrs froiu like those is the 2/POts, frets disetasurr

aIrtan,brnamt A-n

rketr4lntvi~be to-au ciscnrbu,k SOuls Onsiobnt

without the individuals, consent unless thedisetosuaenn foraroonire use of Ibonynleas ofrerorda as published annually inthe Fedcs’ol Regianot. The pchlislnedroutine sacs nfNTDB iafornsnnion, ns-ltiehare consinnencss-ith the law and nineregaladurvsnndrrnn-hichiu operates, do aolinclude disclosure Is the general public.

o The general goblie may out reqseslinforasa lion mat idennilom anypornicelur entity or practitioner fromthe NPDB.

• Medical malpractice payers mop urnrtqsrnl inforntalion event though dutyair reqoired to report.

See §60.11 ofthe NPDB Regulations. Alink to the lVI’Dll Regntaticas in includedin Appendix B ofthis Gtuiefebuok,

Coordination Between ihe NPDBand lite HIPDB

Thu Healthcnee lategri Ip nod ProtectionOnto Dank (HIPDB) was establishedthrosgh the Pro-feb lnenranice Porlnbiiieietntal.ieconusnobili(a-Aco sf1096 (5IIPAAI,Public Lane 104’l9l. This law directed theSeceenan’ ol’HHS nod nbc U.S. AttorneyCenorul no ercone line HIPDB no cembanfraud end ubase in healdt insurance andlneatth rare deliseey. The HJI500 iu000ional dab colleolion program farrcportine and disclosier cesnain Ijoaladvrose actions lakes ugab 11 health careisraclhiouoeo. providers, nod ueppliern.

Toallrviale the hnedononilnosrutinitiesthat moan report In both the NPDB nod sheHIPDB, u system bus been crooned toallow ao entity than en ust report thnn sameadverse oclina to both Dam Banks Insubmit 1110 report oaL once. ThisInlcgrsned Qunraying and Reporting

Senior (IQRS) is uhiets sort theapproptiaie oonioon into nbc HIPDB. nheNPDB. or both. Simitanly, rintiniesanshorized to query helln Data Banks havethe option of quenirn both the NPDB andthe lttPDB with a vinele qsnrnsubmission.

Official Language

Tine ollicia I language of the NPDB isEnglish, and all docnntroas sabmined Isudie NPDB onl,sI besunitnea itt inrush.Dcrcumnossnhmtned is snyother

arc nol accepted.

User Foes

.10cc fees our assessed to cover theprocessinr costs for all qseries for NPDBiol’omnaliun. Referto titeNPDB.IiIPDDsveb site at tnsntcnp,th.h4vlb.eastt fardetails regarding the payment cfNPDB

What is an Eligible Enlily?

Eniitiesesniflodno participate in theNanional Pnacliiinser Data Bask oredefined is the pmo’isionu ofTitlr IV on’Pablic Law 99.660, the Henispi, CaseQisositnn Iss,eros,tie,seos ire of 1016. asastended, and in the regaisnioru crEstedotiS CDt Pate 60. Eligibleeotitieaaooresponsible for meeting ThIe IVeeporfiegand’orquetying requiresoents, noapprnpriste. Each eligible mlin insistcertify ins eligibility in nrder tneeport Inaltdfor qaety the NPDB.

lnfaronotios front the ~cPOB ic uvailable InSlate licensing boards, hospitntn and otherhealnin care eaiilits, professional andersen.certain Federal aoeneics, nod others anspecified in the law, The 109DB collectsinfnrauanios mbaned Ia the piofcosiuaatcnsmpeleoee sad cundart ofphyniriass,dentists, aid, in noise cairn, other Isralslncure prnctiioaers.

To be eligible uo query Ike 0I’DD, anenlit lnnsl be:

A bnaod ofmedmcal csamincrs or otherStone licensing lx.cnd,

A hospital,

a A health cure enniny than ptavidrshealth care services und follorvnaformal peerreo’ienor preceat Ia fatilierquality health care.

a A pmfessiuoal secieny nltan fanluo’nafonnul peerrevieov process to futtliecquality health core.

To be eliniblc to repnrl to the NPDB, altentity mist be one efthc fullnwisg’.

• Meocitythalmakesumedieatmnlpracniyo payment.

A bannS of medical esantinen eraSlant tineashtr bound Boning as adverseaction against uphysician or dentio

• A heutila cart cathy that lakes onudversooli uiral priailrnsnn nylion assrenntlofprofessinnatnevs’cw.

• A prnfcssiuaal sanely that takes anadvent membership acdois as aof pro l’essionsl no n’insc.

tOuch enemy is respoenibte for dctemtisieginn rlipihility to parcicipale ill the NPDBend nose certify that eligibility to Ihe109013 in ssrilirg.

54 napteadrurlnal

thorns Ii EnriCh Ect’ics scent Ouiiatv,nk

Defining Health Cure Eittllien The phrase “provides health care

. ‘ . means the delivers, ofheatth care sen-icesHealth care cosines icrtadr hospitals asd thconsglt any ofa broad artsyofcornoaentheroogan,aations Ihal prosidt health arnangoosoola or utherrelati sitsh’ips withcareorreices and follenn’a formal liter pucnilinncrsoinhto by emphaybnngtheanreview process in order Ia farther qnality directly, or thrungh centeaen,al or otherhealth care. See §60.3 ofthe WeDS anangenneno, This dofnnini on specificallyRegniatienu. A link In the NPDB eccln den ittdemsily inmrers that hum noRegyloli ons isinc boded in Append’s Dot’ connnaetualor etheruorangemem widtthis Goinlrbnask. physicians, denlions, Or other health care

pnctitioaco.Hon allah

Examples ofenber health ease ennitict may.4 hospital iv 6cr‘‘ted nuder S rciiuo include health anaintrnnncc orgaaieal’nonsln6t(e)(t) and (7) ofnhta So,eienlsecno’iç’ dM05), prcfetncd provider orguniianionn

eart at an n’aninslion primarily eegogcd is (PPOs), goosp practices. nars’ong homes,providing, by or under Ihe supervision of relnahililali no cenlem, Itoopiccu, reranphysicists. In inpsticnls: diao-tastio ond dialysis eentees, and frcc-staudiagthcospe”tie errs-lees’, rehobililouioo asnbnlutory’ cone and surgical non-iceso vices formediea I diagnotin, lrtalnntnn,and cure’. or rehabilination ofiejured,disabled. or sick persons In additioo no lIMOs and PPOs, nlher

tnnoaged euro orgnno’,zasiuas mayHospitals mast ho licensed or approved as quality as heatuln oaro oalilies. A healthsteeds cube standard eslablisltrol for care entity mast pravido benlib carelicensing by thn Slang ornpphicabne oral aenieesaendfoll mva farmed peer reviewlicensing authorities, process In further qaolitv hesahlh carets

satisfy he eagihility requirements ofOther llcollh Care Entilies Tinlo IV.

A healshc~eentti t~. mast provide health Esamples ofhonpinols uand other heatlhcare nets-ices and follonvo formal peer care 01115 ties arc listed in ha tnble thanreview process to fmnherqastily health follows.oarr.

a.: Snptashro200l

icptoesot 205n n—I

yronocalrbnoL rsao,ruoainhkocsnrca

Examples niHoapinats and Other Health Cure Entities

Hrspilals Other Stealth Care Entities.,sllrodt,sn and ,oo’Padnal alsai’se,n, oaae A,abslouryoaootpatirsn cane

etenoal mdopeahbyhoapiuta shoe ootisnrnod abnotuthmsuiseptntrfoltmpinal.as c6,,on’ lirnnhmiood ev 0° stout.

. ‘Oon’daotsnncy’ otetots,osstroitssa All rederd — oos’Fedenl loro.n,,m ass od,onsiae paul of, hrnpinal.

aess,al red n5rtoidns hospital, dun ptoui dodsceosniic as4’m tbansprmu cane annieotis •Wuraioe hanoi thu pro-ida tkil]nacsnninr esteespnsinine urn phyti~ aad’on pnyohalua at sainnde, the sspnsiniuo nm mbasioioa or

that ant ironed er rthermi,o asthoniund by the pu~sbol,5mst.slate,

• atespi000 thanpmsid. sass net radar ha.Mongeenn, tUlle] voraisa esrilily anal is aspenicisnorurhydsias nrp,yabelsg’at

nirmnedaealmapirdby,ht S’ue,at lo,gucnseitptrssdodun,ieenhrnape,-sinbast.en a3iaoairtobustsurhptplcmlho0,osjdaoatyph~slena,m psoshoby.sv daily

. .khosp,ueO,apmsid,nabsntodnarai,,0andaomfannaatenatdnthenspe,sisi morephynisias and shinln il lmne,,nod b> ii,. nets

Defining Professional Societies oocielymnsl qualify no a”heahil careentity” as defined in p60.3 oftheNPDtt

A professional society is annembenvhip reglolacians. To meet NPDB eligibilityassocialiua ofphyniciass, denlists, or other requireascnls, a profrnuianai society mutthealth cure practilinacru than folla’vs a fotlouvsfurets I peer revioss proteus forfrtsnal peer review protean forthe pmapese tire psirpote offoitheuingquatitvhaatthuffiacthcning quality health care, care.

thoanspics of prcsfessiooal membership Daftaing State Llcennin g Boardssec’tetira as ay innclude national. Stone,conuaty, nod diunricn medical and dreul A Stale lirenning booed, or hosed ofvncielies and omdemieu efmedicioe and medical esanlilters, is rcnpousiblc fordeitristr3’, Enomplesnfprnfesstanal licensing, monitoring, and ditcipliniagorganizations that ordinarily donocmnsl physiainns. dentistn. or other health oncethe definitinu ofa professional society practitioners. A hoard ofmedk nilisciadeisedienl asd usrgical specialty osaani seas its Index amedicsl erdenialcertification hoards, indepeode,a proetion board, a booed afasneopathio ctstnnn’itern, aassociations 0tPAs3, and PPOn. composite hoard, a sub’disisiou, or no

eqsiivnlenn body as detonsined by’ theProfessional societies are ‘tot Sow.automatically eligible to qaris aads’orreport to list NPDB. A professional

yrrlsn,nrn 2051 v.a

Csevm a ctsart tetisa span aasatbrsk SPaS uusdtsaak

I)etiniug )Iodteat Malpractice Payers

A medical malpractice payer inns entityhot mains a medical nsalprnesice payment

fur tire heaeftt ofphysiciass, dentists, orother health cars ptaelitioaees insettlement ofor in sniasfnetarn in ss’hole oritt gate of. a claim rrjuudgmrnt admItsuch pracritioeer.

Registering with the NPDB

Eligible entities are responsible farmeeting Title IV eaponing and’or qsrayiugrequirements. Entities not curremlyregistered with Ihe SPOIl are responsiblefordeterminiag Otcireligihitly andernialrriog with the NI0DD by completingan 5)itiy Rrgitessatioa fetsa. A Data BathIdtntiraearteo Number (DOID), amer ID.and a password me issued launchsnecesauially registered entity Atm entitythat dues not have this inrorrnalirr in rotregistered saitit the NPDB act! wilt bearabia en ssbmit reports sad queries,

the SAnity Segiartorioti fonts stay bedosvmtloaded Dote the NPDB-tItPDB suchsite at tnna’.ttpdh.stjsdb.cott. The EstatesReglalrtunina ferat atlanta eatilies toregistersitooultanrons’ly for both the NPDBand the Hrntthcare Integrity tadProtection Data Bautc(HtPDB). Theiefora,stiott requested ott dtis fontpreside, the NPDB with enoenl’tntinfnnuution enoceming sour entity, suchss srarorgauieatiru’s natoc addressFederal Taxpayer Idetnifrc.stiotn Number(TIN). nod type ofossnoership; ynnrereanientirn’s tuahurity to pausteipate inttte NPDB and the NIPOB undereach nfJut statutes governing the Data Banks(title IV for the NpDB; ottd SectionIt 20E fru the Htt°DB1; ynsrOrganizatiaa’sprtmatst naaution or service

used to rrqoeso deartivotiro. TheDeactivate DBtD optiro must hectteckedend the requtired nectiuas ofthe formcompleted. The reason ford’~a~tivau~totmutst be provided en the completed ferns“hen tots returned to the NPDB furpoecessine.

ReacIn-ate u DIttO

Ifyree eerioy’s DOD is rurrenhly mactireand y-ua determite that it sheold be active,

~ourtttti~”sue~fy’iug~fflet’at stttsldcenoptete on Suitor Regtulrorioo fogs,Select the Reactivate on Entity optiue 01

the form to reqaestthat the DBtD bereactivated~ The reason for reactivationtouts he presided at the completed formwhrt it in reotrued to the NPDO furprneessine.

User [ha

Entities can create msltipte uneeso that multiple depatuuettatpenpte conustthe same DRO fee qaervitpaadtepotting. User los are Ce eased andmatotatoed ttuoagh the tQRS. The userDan entity recetvessshesititiuially

registern with the Date Dunks is theudmitmisn’atoraecouot The adminiufrataroversees ott other urn IDs nod st ruttyuser that may add. update, and removeother user uecostnts (user los). fan entitylas 0Ol~ cue person who sacs the tQRS,

the emttity may choose us one theud,niuimrauar accotmt as its regal Sr useraccount. Fur mare it fere,atteu usestablishing mnltipte tacos, see theNPDIO’HIPDO web nile.

ttgadolu Entity Tnformntlon

tfyasrettitf’n name, addresa, suarsturv-. sutltouiuv, organization Is-pc, ecrtifyitg

official, or say other itetu ufyuoe

(ce., entity type); anti, fur those entitiesanthurizedha law laqocey bosh DataIootks.whetherqseties atstubessbmittrd to the SPUn utter, to theHIPOB ottly. or to both Data Banks. Thisisformationaitassn tha ts’PDB to registeryour ettity’s uathotieatiat a psulicipute itstlte SPUD, atd up detue,aiue yoncettity’srepotsiug anther quetyinnreqsieetneutsatd resfrirtieas.

CernifrhseOftieiat

A ceotifyine official is due motdirmdsalselected and empowered h,v an entite, uscertify the tegiuiteucvofregi,nssutiuu foeparticipation it time Nt’tatu,

The Enevur Regiuurooioo form coolsiuscertit’ueotion infotn,olios that muse becootpleted by all eteilpu eerti~ioeofliziut. The eotlty’sccrt’tfyitg officislcertifies the legitimacy of thr rnginl,utioaiafanratiaa provided to the NPDB, Thecctsiftcotiouu section must contain asoeietstot ink signature usda signatsee dale.Faxed, stuoped, ur phruonopied signalneesate ttnaeeepeable, The title ofthecertifying ofteiol. a telephone aumher.atal ate—mail addrto mast uloo hepms’idrd.

Once the completed Sourly’ Regintruriuu,faeenu’nenceivedmsdproueused,theNtsDBannigt,ssstt’qae, mtftdentiul DDID andpassss’ned mud scuds an Sottip’ Rega’slrouiu,tP’ea’giieooloe deeatuest to site entity. ‘fluiudecurseul cantatas the entity’sconfudeutini DBID. user tD, and patawoad,as welt as the it famtntiet that wanprorided laths SPUR on the Sooty’Regesrrooiatt l’ot,a. Theceesi fyiog officialshould tend Ilte docuaueetearefn]ly nod, ifthe doeumett roata’ss atyeerorn, followultrinsuotctistts provided on the documeotfor emeecting the toanenmee imsfortuaniot

registration isfortssaoiout chances. youretttitYscenifvioo official sltuald ubtaioand complete an strulo’ Rugcstru.odaut formfrom the website, and select the ClrangnEautany trfenmstioooptigt,

Yes toast update telecsed puotteinfomsuuist via the IQRS, A fter leecioeinto the IQRS. you will tee the SnottyRegcetmfiout Coulfirmogioutsceeen. Selecta bnltau at the bottom ofthe ,ceeeo called£)aulrale Ee!iay Patafude. You will be able tochangn the fallowiug ioftemotiro;depann,eutname, ttailh;g addicts, e’maitaddress, atd Torcpayer IdeottiteudonNumber (TIN). To update auty etharettityiafrm,adon, complete atd email auu EsaiorRegosorauisu form as described aboce.

When the SF050 reeeivrt apdoted emita’infcsnoanmut. the updtted itifomtatlst itprocessed into lt,e NPoBeompstersyaiemand as Ladies’ Regina’ooioo Ver(aieut/oadocument, eeltecliutg the changessubmitted, is toiled to the entity’sreenta~mn official. The certifying nIlicialshould read the document meefutty’. lfthrdocssnetr cernshsnayeeroes, fellow thelustotetiots provided at the docu,nert foreurrectiag the itaecuuanu infoomatiun.

Lost Your Both?

If you canaan remrmber your DBID,ceolactthesPDB.HIPDB CuttuuecrService Getter forausistoater.

Organizations ThatMoy Reportand Query on Beholfoffflolitiet

Authrrizcd nsbnsiteees ar unthecizedaeeuuls may nahnsie qserles tod reports andreoies’e responses from the NPDB onheltalfnfregistered enuitica,

The ceedt3ritgoly,ciat m’y a laodesigeatean atntherteed agent In queev aad’er reportat behslfu,fthe entity by cnmptrtiueAutth.srixdaggcog £tnstisssgiou. foam anduubmitriogitto the ls’pDm. (Specificresponsibilities ofantherized arrsts aredeacrihed on pace 0.7.)

Entity Rrcerutfleautoo

The SPUD ptciediualty wutoim, emitiesnaeecertify the’me cli gihthl~ At these time,.the I’iPDS smds to each ard cc e.uliuy thecurrent ideudtcatios lofurtualirn on filewith the 115DB. The euttity”ucetsify’ingofficial should reviess the iofansrstiot toens arc titan it iseeu,rcc, itdieure dieentity’s appileahle eordtimtionsntement,nien the document, and return it latheSPOIl.

Data Bank tdeatirtentiunNumbers (DOIDu)

Each rttiuv that reot’suers with the NPDOisnss’tgaed antique DBID and pasovardaswelltsatioitia!caneto DfltDsatrused to idmtify registered ettities andaathoeizceagesutu, atd mast be provided00 alt reports, queries, n,rd cotrespoudenceasbmiited to the Nl’DtO,

A DBID in a link inta the is’PDB eunupoter,yttem and aheutd be sufecuarded topuevettt ieedvennettt diact asaeu. It isrevealed only to the cushy ura,etuto

uith assigned. to the eveat thai yourentuty’o DBID is contpmmised, fullour thein,lrttetmnas in the Deactivates 01110secttoo.

‘The assitsasrrtl ofaDslo isutrtarepresunmalian by OIlS than asentity meels‘he eligibility criteria foe paosicipntmontutthelS’PDB,aaspecioed it theHealuh CoreQsmliiv Jmpcotvoucaai -leo of’ IRe, as

amended, and iii mph euuentiogreetnlalirns, ii CPR Part tO, loch etlity‘nreapeosibte foe deteontiaing whether itmeets the eligibilitycuiterin attd foeeertifsisg its eligibility Ia the SPUn,

DhlDsurraasipeednatyeo eatitiesthamcertify the’me eligibility to the SPOIl and totathrmieed arents 55 ho oct no behatfofeeginseaed enmities. Onus are tatassigned no ceetifylag nffleials.

mactrail sebmitlpes or etherled ivitluals sesuctalcd with u reporstotor quen’tug multy. However, ettitiesmay create mattipln 05cr uccomrts tunertony foraciren OSlO (net due User IDsection in dna chapter). For cccli user IDlist en node,, numablishra. the entity muss

also create a separate pamsno-oed. Pornmnreinfrrmuutou us establishing multiple userIDa. refer an thu NPDB’HIPDB sceh site,

Deactivate 010115

Ant rtmgihlc entity mm reqaese at any timethat ha contest OHIO be deactivated atd anew OntO assigned Isy selection titeAssign Ness Unto or Deactivaig 05010beset atm the Thtiy’ Regisoreniout frum andcompleting the required sections. Faet,sstuncr, ifyon belierettuatyourenmity’aIBID ms been compromised ‘m any sssy,

or ifyose ettity oserges with auutheeentity, you nuy ssixh to deactivate race01010 sad neqnueseaeew our, Yea mtustprovide your Teases for reqsestieganessDBtOoo the comptetcd form when ti isreturned to theNPOB fnrprocesniug,

Additionally’, ifut any time. yonreulityretinqa ‘nhesehigibility to parliripate in theSPOIl, your entity’s certifying officialmust notifythe 55DB in writing todeaceis’ome’oueeatiuy’s 01110. 11°c Enrn)yRegisan’ouento fena, which can heretelevedfrom the NPDD.HIPDD ,n’eb sine, nsost be

a’s ietnnohor ami

ctmaceeurtsruteuon’ssan hyat Osldatauts

narcmhsrstor Ia

50,05 cunsairob CbntOntiitctniers’a~

Aulhoein,d Submitter acgan’uarien lC’.’O), ne rogmienti000 flatmaybensrd fCe ceuutrulized credeuttmalieg

Art authert‘ned subnuuteris the lodis idunt or gmet’essiooal ovenipht, such as Iheselected andoapassered by a registered Nalteuunl Coeneil of State Boarda ofentity to ceovit’s- the legitimacy of Naming and the Federation ofiefore,ationpros-idud it a qaery er repetm Chiropractic I, reusing Doaedn,io the SF010, I omnsl casts. thensthoeieed oshsaieeris an employee ofthe gnuiriesntuuse ensure that certain onide miresorganzation submitlion_ the report nr are fottoss’ed ohen desigutating atqaeoy, such as at odonicimornour, a risk aamhogiaed cIcaDa qaer)’ or repast rotmanaegr, ne medinat alaiTnersicea their behalf, Th reality shustd e,tsbhsttpersonnel. The NPDB dccsaul assicn ssrittee ogeeem cot sstth that autheeis’,edDIotDs to atmntmngieed submitters, agent rntfueatior due follosmiog;

Entities are reupotsiblc Inr srlecmiaeuhetr n 1 lag agent is authorized In cundautauthomieed stobunittrr, nutd the submitter hoar tess in the Shite.muy change at only rime, Eofluien may -

choose In h as-c multiple ruhtoiners. Fur • The ageat’s fucitit’uesarc srcsne,example, 00 utlity stay designate a ensurt’ne 01 me eettftdeutiulity efNPOtiparticular iudividnol within the respouscs.wgaoius’ntion lobe the antharized suhtnimierher repen’ua,g eat! anotheritdis’idual to be • 11 cogent isnnplicitly proltihited fecetthe authorized suhmhoee ferqnes,’ing. asieg’mfaonsdeo obtuired fmns thelime anthetized uthuaittcr is often the 751’DS I’ne soy pnapose ether than thatmndivt’du.ti designated by time eegnniaatinn far wttitlt the disclosure scan node.to uabstil and retrieve report andre qnuemy’ lerexansple, oco ditrereni health careeeopomaaen Doom the NPDH, I Inss’cccr, eelities design ate the same unthoti,cdpnnommel cray bedcsignated us desired, norat to query flue SPUD on theirEutitim ann aol required to register he holotf, Beth lteatdu cant ectitt’cs,n’i altauthorized nuhmlrteror 10 ideal’mth’ thou tn reqecse iufnrnantiou ou the sautepensoo by name ho the SPUD in ads once, psscdoionrr. lime aathoeized agentttthoaglu the authorired anhmitter must iutust quers’ mIte SPOIl separate IF Otpeoride hisne hername, title auldnshore belmelfofeauh health nareent’uty, Thuunmber at the time a quem)’ re mpoml is respouse to an NFDB query’ snbminedsnbnsitied. forona health care entity eanttot hoc

shared with another Imrollh core.kmtthnrieed nbgenta

a Then gent is asvnre ofthr saucuiorssRegistered rntitiet may elect to base I bateau be tah rum aeai,isl the aneet ifoncide orgatiraliuna quiet), or rrpoet to inleusu. tint is requested, toed, ordue 5500 out them behalf. Snch ot d’oetonedinviolaeioo ofNPDSorguuiaaties is referred tomattantiaorieed pos’aious.agog. Tans ant casen, no auathurized agentin ass independenu contractor wed for • a~uthurieed agea inare rat utiuible uscentralized eredentiattog, furexatople, u access infant amioo it the SPUD undercounty medical socicly,a Stale hospital theirosuss aalhrmily. Theseaanociauien, u credentials sen’Bcaliou

naps,msmzwl auu-u nopaeanbae roan

rbareeo ucltniotstossnu SPan Gsiiehenk Span fraijetentClose Is rititso uttisico

organizations and other argaoizoriorusthat do not Inert the solute’s specificquery eligibility criteria may onlyinteract with the NPDB as authorizedasrntn. Authorized agents may onlyquery the NPOJB ,sith the authorizationofon cligibleenrity(i.e., the eligibleentity most desigsote the authorizedagent Ia act en its behalf bycompleting the Aolr/eorlzeuidgeuslDan,~uaeios faire) far opeenlicallydeuienaled told limited paqroses.

The autlnorierd agent 01051 hnvznespy ofthe moon recent Goridctiuuuk (wliiclsincludes the ecgctalions und the civilmoney penalty regulations of the 0l1’oce ofInupeetor General (0101. HIIS. at 42 CFRPorn 1003) uid should he ussare ofthesanctions that ems be taken ifinfarmorionisnequesnesi, used, or disclosed ittviolatino of NPDB provisions. TheKeogh, Cure QsoIrA-Jiajapus.s’ooeut dci modthe OlD’s civil mote peunlnyregstlationasitanizesupeno by of up Ia SI 1,000 foreach violanion.

Desiguattog Authorized Agents

Before tao authorized ageut may act onbehalfof on entity the cr,tilV mustdenigatate Otto ugotin to interact scith timNPOB no its heholf. Registered entitiesthai 55mb to drnignote an authorized agentshonid obtain art zfuiltori5rstalgemLksiwruas000 form from tire iOPDS,lllPOOnseb site, mc entit must complete thefeon. prosidiog the outhorirod ogenr’nname. Oflil) (if tcuussss), oddness, nerdnelepitorre owuberi and the entity’sresponse routing and fee paymentpreferenren~ and relum itta the NPDB.

Ash, orized agelrtsm105t he rrginnzrrd sciththe NPDR beforr they non he desigaooedto report anodize qurryos behatfofeligihteentities. If the ogeuti tool registered with

the NPDB. the ngentosuo ebtain OsAoonloeoizs’ddgerra Regtsnrerioa form fromlire NPOB’HIPDB web uile. Date theao,tt is registered, a 0000 aod apassword is assigned to that ngeot and theentity coo desigautnotonl neent no reportand qoem on inn behalf.

NPDB reupoeses to eoporns and qseetessahmirredhvoeaurhnrizedagertrsvitlbrranted to either the eligible entity or itsaedtarized uceot, ~y tndirared by the entityon the .Oonltarinasldg000 Iiomeigoalintrams. flits entity wishes to aetsiereresponses itself from the InteeraledQroenr’mn and Reponling Service, the cornymeal hose uecesn to the tntemrt (i.e.. onInternet Service Provider) and anapproptiatrsseb browner, Requleementsfor using the Integrated Qtoersino andReporting Service can be foattd on thets’POlt.ttlPDB Itch site.

to addition, aplog.ilt or nened-nlooepragesnt that can read filer i,r PortableDacultiert Format IPOP) is required, ouchas Adobe Aerebat Reader 4.0.

An authorized agent ,hould have only notDBID, even though ooore thiso one emilyaray designate the ogeat to query redreportlu the NPOB, Iron nsthariaedageen boa been issued more thao oneOHIO, the aat harized ogean uhosld oblaioan Aoolftori_’edAgean Reglsnritniutr farmfrom theNPDB’HIPDIO sseb site, iadieatewinch OBID in intends to use, and requestdrag any other DBIDn bedeantisaled,

Auvehoogestaanautheeizedugertdesigsntioo, such an a clnarree to responseroulitig er termination of an aotloorizrdagent’s asatherkeadon to qceoy mid eepoetnoon entity’s hehnlf. must he artirnalnedhtthrersthv. lfehangeu in an cutherizcdogeno desieoagiou are requined, the entitysheald obe,in on .irthnrizedAger,a

Deuigr,uuiotn forte from the Nt’t2B’HIPDBcite, select the Update Pneeiaos Agent

Desietraliors eptiao en the fairer completethe form as dieecned. nod relsrn ‘INPDB.

All focus should be mailed lathe NPDB:

N PD B . I I PODP.O. Dcx 0832Cltantilly. “A 20151-0112

Qoescions nod ,~itsts-nos

I, lion, doll.’taessifmyorgaoirsteiooisno eligible entity?

Sen 060.3. Oeftoitions, ofohe NPOBReau lad one, A link to rite NPDIIRegulations is ioctoded in Appeodin Roftitit Gr,itlebssok.

1 Cnn abe ‘Won certify or verify Ohattoy organization ineligible to report

Each entir, moor detnamine its oosnteligibility no poonicipate iu the NPDB.The asnigaroteno of a OHIO is totercprcneolatieo by I tie that voworeatt marina nsrass the elieihilioyceileeia for pannieipatiao in the NPDIO.as specifted in doe HealhPr Core Oazalio~’Inrpronv’eretri 4cr ofiP&6, as anreoded,and its implemcotisg eegulaoiam, 45CH5 Puts 60. The 1*010 Regulations,ioeloded as Appeodin B. describe thecriteria for eligibility. Otherirnfeneodoratl maleeiandesigsesl tohelp you detnrnn’me yosrarcanizatiun’s c ligihility east heobtained feant the NPOB4ilp010 sseb

Oven’view

NPDB qnetyiog and eepooninnreqai remeens apply to physinians. dentists.and other licensed health corepe000ilioceaa. The NPDR nets as acleteinglrotse of iafarnnstioo relatisg tomedical malpetetlee paymenls. certainodrerso actions tihenagalostprnctis’oiteen’ licenses, clinical privileges,aod professiaoal seciety’ memberships, nodeligibililyto paenieipale itt

Mcdieaoeiased’tcaid. NPDB information isitttended robe used in combination withinfaetnsnioo from othersoneces in looldogdetertoinatiots 00 grantitenlinioulprivileges or in eatployoienl. atrtliatioa, cvlicensarn decisions. Table C-I, ,‘!PDBReooirerresra.-i,tkeeisgplgrofelaasn,Dew/art. o,td Other MoaN, CarePamaeetoiooreru, snmltsaeizes Tilts IVrcqaimmenoo ulTeetieg physicians,dentists, and other health careplnclilionenu.

Dcrttnog health Cafel°faclildaners

A phys’oetaio is defused usa doelor ofmedicitteorostnopolhysvlto is legallyao,lherizcd hs n Slate to pmcdeeotedieieeorsuegery. Adeioulseisdettoedasadoctor ofdensal torgecv. doctor ofdrntatmedicine, or the equivalent, ssho is legallyauthorized by a Sore to practice dntlisla

3. Does my organization have to onti rynine NH) Owlteto sic Itave aenrnifn’ioe official?

Yes. Erg elieihte entity g~Ices berertifsittg ullirial aothneits an otisifythe lecitimacy ofreginironioninfntnnation provided to the 1*00.The person autheeized by the entity tasneas rite eensif,siag official maycitaugeal an~ time at Ike diocrrtion ofthe entity. hiessener. tl,e M500 mtkcso recaed oftho stadftide and tame afthe individual assigned as thecc td fume official and should henotifted sshetn chaises tenor.

4Ev bospinal merged ssitl, unonherbaspilat.ood boil. hose medical snareofftcet. Shottld we contlote to qtue.,ocparuletv osieg in-u differentDuDs?

tfthr hospitals e,aialuito vepsoicmedical mu I1’eredennialing. thehospitals should qnttystpatulety.lfby applying to one hospitalpractitioner is granted privileges nopnantiee at beth inssitntioss. atehespibal ohoutdqorny on hehalfofbeth innrirsoinsnn, Hswcvee, bothhospirolaslts’ald be Inane list ifoecDm00 is denrtivated. the NPOB willtnoisoain ontyone hospital oddness nodattlyoae”etecInosin oddres, — Perloam iril’oonullrion On qneiy resparneco.seoCham,tero.Qsoiies.

Auy individual who, srtitheutaothaeits.,Iroldo himsetfor hetselfoslno be atatthueized physician or deuliotinconuidered a ptttsicion or dentist

Olluer health rare pmceii’ioners aredelleed is individuals ether thanphysicians or dentists nito nag lieeuuedor otherwise authorized (cecirredorregistered) by a Slate Its pmvide hnatdtcatv senleen-, cc iodividuals nrho, wi’houiauthority, hold thnmselves eat to be solicensed or artthorized. Feresaoa p len, seethe lint aa page C-3 entided Ecuss,als’s o,o’Other tlraloh Care Fh’oeosinnera.

The tieensirtg or autheri~ta~soofatheehealth cane practitioners 10 provide healthcane services varies from Stole to Stare.Each entity that reports tsar qttoeies theNPDtS in responsible fee delenaio’ragsubmIt categories of health campractitioners aetlienncedarothenyisrauthnriecd by their Stale to provide healthcare Services.

Cuorenila, themisionnnPoBeequireasnotto query crnepoen another hroltb easepractitioners sshn one not licensed orothersvmne nuthreieed b aSbaee to providehealth coot sensicos, unlesn the indiri dualholds loimorlfon herselfna betanatherined.

n-u

oir000sssoosu

n-i iupuehm not

(Super 0010,55 Buttes iyOunlsldnsnsk

5. My organization presides m reunurco e. Coo ttoyornaoizaoioa havcmorethat idenoifien praoiitt onira si -ho than our DUb?mete mini mnm standards asestobtithed by the srgauizatinot. Ifyoa h ave mold pie depnrhnscnls OrDoes prndueing thb list .aouke my people v,hr handle NPOB qoerviognrgnn’oaeiott ef’gihle to purlieipato tsti’er rers?tsinr. you roan. ncg tortin the NPOB? each depaannsrntooyeesornneparanetts

trtd us eden separate 0010s for eathIn urdee to be eligibln to participate in one. Hnsncver, deparbnrclrls or peoplethe 1*00. am orgirtiradeo mast meet stith ditTarrnr DIll) ermtoi nssintooethe dtfmiticn nfa State ticeusine ooather other (in., rae depattosenibeast, a hospital, or other tim tilt earn eannil download a resp000e from ae’ttily. iroel,siin0 a profess’tonal society’, query entered by soethee depaiheue’tlas defired in this Gorideb,ork. lfyoar nsith a dilfrreen 0000). Also, specialorgnniantiart dee seat eanfernigltlu or cart tatlst he noken to be tire that theresponsibilities ofmemt’crship one sasooc queev or ropans is net sshmittedpnardltreee and caedoet fomoal peer twicr.rest’elv, it dogs nat mretdre dclloieieaafa professional sreiety as drsceilsed RaIltee ttoan rogiulering fur multiplein dte NPOD Regalati nno and es not 00005, an eotits may chao no insteadeligihle Ia participate in ire NPDI3. to niosply create ntnloiple onernun0001s

(ic,, user Os) nader the oman0 izatizoi. Ilitny urgnntoatioo qeeries rIte 0010. Usior rite IQlnO,ancuiiny gala

NPOtt, ‘0 it also required to rr1rore? establish as many os er nceelatu asCotisersdy5 If my oretnizanion ttreeooary, s’td Colt deoetiyots thoserelauros in rho NIeDlI, ‘is to arconltos iteelfsshen eeednd si-lit ensantominoiently elieible to q’tcn’? deactisati og ins 0010.

Nat necessarily. Sec Ctnaponru 0 andE, Qner’ret and Reports, mspecti’ely,for d’oset,stiaas on querying nodrrp000iog eligibility eeitrn’o.

7. Are PPOs dinible In nornielpate itrho uNPOhs?

PPOs would earmally be eolssidrcedao“providier” health once services. IfopPO conducts famnnl peer review tol’nntnrrqaatity health corn, it “gold beeligihleto paerictpatrie tltr NPDD,

0.10 Sopbrrntbroeotc.t

C sloe C laos tO Con Pn cOs icon. NPDflGa00000rt; Spas Oseithook

H,nhh ConFeaacinion en,

OBL-eef,peeta,Onienol (0101. lOSS

Mon r a poamsilo d~ far th~ hnrfo orphtsioiodeo,iaso.e,dcibn,hml,haaeepdonnes hi senln,sn,,i nIce in

in sshole or in pan sea olain orricnn.i.....s.~nasinjoo,o

Dans,00poi000theieosn.bah.Z

Repono esslaninnofram ‘hoMedicoccwe0dicaid poscnmo o0,inuiPby010i.oo,dnslisio.mdnlasmlosolthooostsoniiliaso,.

CosoonlorCuossolo Orniel HealthPeofesohs.lfaaonatarPnokaassai foasnalo,-. AlaeloolFaf0005asalfnseloe.FoodooMnobaePoolnenianl Cosocelo,. tcbnnonoo Àbas.

Ooluarslnopcn.idsrDon 5. I A isis, cotDns5.lllvoiosiaDrsssi,t

Dl pole ia si5n ri n Ia 0 IiDinisianNotitiohis

F.meptpnq sloullralTeolmlria s(Esfl)0307. RosinEast. Cendinotoidral Coreestq leteesnodiata visIt Faeaooedia

ycsrsetldnaoedrrne,ic,Nn,s,Rnolatreed lfiobsoioiatl NanNan so the cc tfra,lolNone IsOduileNo,sapooas,io,,enLiaeodP000eioeVoenoionnolNrnoe

P100m Ald&ulasn. llrohh kid.N us, es A ideHone H ealth A ida Oioc005dsasj

L~r und Video ‘tenon Pesisidee00 ,d ad noOptiolnoOprs’ntcnt

Pit. rmnos Ones leo Fr’s OdorPh on, no laoPh mnsn r is Noo Is orPlooaaayth,,io,oi

Plisaidon thoshlonIPhysiano .ianioaui. AliorelniePlqsnioieo Aaa teL Oonoarsthia

Podinnel, PeridotPod Is at inPolineta snub,,

Fe ol, sic tiul. Cu ose.t

lnebnbillinore. Rep~rnnses. nod 000nornlivrSe,siue ProslirorAnctgeo,onnire The,.uo‘‘fls°er ThospintOrespohond Tiun.pioo000sraniouoal Iharapy Assinna,uoPhauiol Th,nopisiPhydeol Thospy AnnisnerRebabinaiko, Theasa1ohlRnspisson,ymenpio,Respisiatoty Thsuapc Teobsicioa

apemlu. Los ‘‘r°. and lieanlotl arnie,ProviderAsdiolanicoOpeenkoL no n~~a a e Pa 11,0 eric

Tee it o a loni, IMutiiedTosheolsrissCytoi eel, so Oag isNoch., .sluditisr TnrhsoletioiOaaicdou tiso,ops rosh,s,teoi,,noolietoeic Trrhpo,logisl

Other lleallh Cane FranlllocnrAnopsnasa,inAthkuio TuainsnIloneopathMadio.IAssI,imiMidsOib. Lay INin-soroniNoiaspothOsd,elkoaPc000henioa lanePaniaiooj,iFoblitnia tesloliocool

Poaclilioner Soil-Query

A solfiqoero iso poacoiniecer’s requral forjitfomianion shoot hissoell orluersoif.Peccoini050nniaysrlf.qociy the NPDOand 01,0 I1IPDB an Otny timelovvisiiiog due NPDBtIIPDB web silealunuiuc ‘tgofr-hipdb. coon. All noir-qoerynpplicuoisnonnasn be stulinojonod thronoghthe SPDB-HIPDB web sloe. Preciouspaper Versions of lion Sri/-Query 101,0will be rejecled. Practitionoas who do nothove neceau no the loleneet ma, call heNPDB-NIPDB Costomer Sen-ice Coslerfor assisiooee. For detailed insb’oclinnson aellqnunying, oct the Fours Pincer o~sSr1f-Qezo~iiog available alnts sjadb1e(osfr coo,

A praclitioner oh asob,oiia a solf-qucos Iathe Darn Bco will macito Via tJ.S, mailaithora response ocnifsing then, than noinformation onions in nI,e Dana Banks. or acopy doll report infarmodion stlb,ailled

lay eligible Oopnmlingeclilie,. Allpreetihioneroelf-qs,ries will bc processedaaai,lst both ll,eNPDB and cli, IIIPOB.Acparnofthoieself-qoeny reoponne,sobjecla elan Advc~, ,~clion Report orMedical btalpnacticn Paynnenl Reportanbasinod ,n 11w NPDB will receives listofall qoeriess Ia who,, nbc reportedlofoanisaties has been disclosed with the001ptstnae.

AllSelf.Qoe0 forms fool be sigeucd andnolllrioed, and all Bold, in theaanorizalion section rnsst be coloploted.The NPDB-HIPDO “ill rejean any selfqarey received nfilhool sigoatore andnatniizaiin,n or nviih an encolnspleleIn510rizaliec.

A fee will he charged far ends solf-qoentsobasilled. For mere information on ‘elf.

- ) qneoy fees, refer to Chnpter 0, Fees.

Scif.Qllorying on Ike lnlernet

Tine NPDD-HIPDB eospleyathe brentlechaologss. nIece snub vaeions,mplernennationonaeas,ieec. 10 provido a

000ieolmneol for qcenyiog.eepoolioo0 dab snoenpe, and renrie,,Serarira feats,,, icelode firewallproternion ft ann oinamhorized access andeacroplion 0 flewssmilned data no peeveal“moth orized ott.

Pr.ictilianeos conup lob ‘ad nca,,nmit theirsolf-q ocriostonlse NPDII-liIl’DB on-line;however, a neld-qoeny is net officiallyslabminted onlil a sieaed and notarizedpaper corn- is received bythe Del, Banks.A fomsaoled copy of the tolf-qo’eoy in

pollenatediomn.dialoly albert lecteonianoansonissian. Tocooplele the self-qneoyprocess, peaetisleneos otsst print lineformollrd copy, sign and date ii in thepreseecee I anotaev public. sod mail thensolarired self-qnorv a he adder’sspeciBed.

Dote, a propcrly sinned ard nclarieed aelfqorry- is received bf the Darn Banjos, ill,)nieally ia processed within aloe bsninessday and rntnmed no ilta peactinincce viaU.S. nail. Tine pcacninianer may view thaprocessing atatan ofitisor herself-querymeqn.st via the NO°DO-HllDl5 s’ab site atIflflvoqadb.hipdbccan

Snnbjevl Infor,naanion in Else NPI)B

The N’PDB in eam,ninlrd 10 nsaianaioirgaccurate infoeoallicn and nnsorine thaiasbjeens are isfessscdsshon,aedio,lmolpracnicepaymenna or adverse actionsare reported about then. isThen nine NI°DB

a report, the lafeennalias isprocessed by line NPD Bcounpoter ssisneoaosacnly as ssbunilled by the repornisg

NPduOsdusasL

outlay. Reprising cannieR are responoiblefornitnoecorney ofllaeinforlni.nnios ‘heyeepoft

bMe,n theNl°Dbproaesses aeepoa,aRepon l°eei/ieoclol, Docanwn,oisn,adeavailabienon be eepaoting cathy forrebieval lIons nbc lolegraled Qaeoying andReponnicsg Sen-ice (5QRS), and aNalf’sroliooofo Rn’jsa’-ebn cite Dot,,Bocoail4 is scm Collie snbjecl. Thr subjecishould resiess lIe report for iccotacy.ircbodingeurresn address lelephonenoatbee, and place of employnauenL

Sninjecis may 001 sobanll changes Is

reporns, lone icfornsntioa inareporo isinacacoole, lie snibjncl mlosi corbel Itorepooningeatiny no roqoost than in lile acoirerliontothrrepo,t

lIthe osporning eooicy refines no cereal thereport, nbc ascobject ala report may;

• Addaabolennaensl000nerepoos.Fs,fanu a lisp,one ofthe report.Add a slaneonenn and lainiatesdiopone.

For more isforniason alsoot the NPDBdinpate process, see Chapirm F, Dispoies.

Quesniona and Answer,

I, lion don eorreel tony address iein issvrsmnginareporl?

Voan,osncannv,cn the repomningeo’nina(identified rn both the Noeqireoonn of

Report ion the ,VPDB aad Se/f’QineotResponse docnmcai) and reqoess thainbc ennimy coned the address onrepent lIthe entity doe, aol honaryaw veqt,csn Ioeonrcetnhoia500mxileaddacsa, ~so can dispotr the report.

Charu, C llaatS far Fasoiisoa,,

2. lam a prarlilisner who PeOsOuIO ifrofonded a fee lea pnliooue, Is tInserrand reporlaluls no Ike SF05?

No. A soloed from a practitioner’sperunnal fnnnds is not neporlebim.However. ifthe Ce landis paid by na

nay cathy other than aniedividaol pmcninioner (inalading apeofnssiaoal srrs-icesconponnioscenpnined ofa sole paadlitieccr). therofo”disreponchle, Fernnoreinfennnnetion concerning NPDBrrpoanina neqaiminenis, seaChapnerr,, Reports.

2. Can a hooplnal, Sb Ic Ovens logbased, or medical malpracticeiouorer require linen I g”s’enlnennthe ressnlo of. noll-qorry?

The rospoose yon’ rstceiva no ‘self.qncny is yoaes no do with as yasssish.is’nelass licrnninag. credennlaliog, andilusaniegncliliesonay’ reqaire 0 espyofyoor query before solo maypaeiicipale ia their pcogamns. Anyanaangetnesr bcc,seec san and one ofthese enninies is reloasa,y. HHS dotenon rennlaie aocls anw’geoaenlo.Pfss,res.er a rc,0’ afo slibjc°c’c sac)’qic’,ys*coonoiuoaisj5sonliospaol’slegcdreqn,ivesnna’n,ooo

Table C-I. NPDB ateqoireuuenin AlfeelingPhysicians, Denl’ofl, sod Olher Health Care Practitioners

Examples of Other Heolib Care Pearniiionc~

Ttnr folios-ia0 list of health cane pnactilianers ether than pbvsi rians aol deatisis is providedsciely Icr illosaralion. Tine inolasi coort~-clsaiarolacy 11,0111, care occupational groo’pslmald nec he inocrproncd aeuusandaie or,wai rev of roenpliaece Ia Darn Bask reportingreqnlemeons, si,nec licensoen and rertincanioo reqeireccenns san from Sm,. to State.

Ertlas- RrporlineionheNpom QocnineohoNPBB

satualodisol and Mon OoasOs corals oAses,, itomssc, suits,, Moe ~nis 0 sty timeDocoal Oouodn enbated It pcofsoninsd 050pnnmrs a,

p0000noi000loadooaadnos.ilioaa loot),fiohiov4eroc)aonanddaothoL

Otheneiatsl.icoouisg Do so naport. Mop qoes) no me lion.Sosdo

loospaals uod Dais, sins, n,l~~o (I) pmrnsuiasat nesins oeto000 Hocpi’alu soon qsmy slonssmrsionlirdthfeee cannon rolesdne sc’reouiseolsomposeoneo, uppliaoa!afnn cmod,sal .saif.pprisasonn

pmfon,ioaal cordon ‘haiadsssaly cnFeo as ,01asiaetnddie, loiespaedae,itnin.lolioied pnis,leges ofa phatloils Os doom pnisilero, nod esep 2~on,ssn henldi careeon noose than 3d dose 02), rhyolcian’s or pnaedda,uos cnthn o,ediool euro, s*luodeotiso’s sattosaso ss,rssds,arme,ioion or h.soolioiaal poll lean Hoopitol, s~rl,c,cal roisilnee50000iln ‘color ms noiganiatu (‘0) 0 dlbresiosea, Os does dana,ltrpnnfussloo,ot eas,pesooe orpoctosolood rea0000q. Onba, hml,h noesensd050anoilumnsnsforeeleondaoi,voo qssoslossau000isg.ppli,aacsfo,otosestikatiosi i’d l)l,osisitso a nob csediool ntoflrappcioouuor.t oi claotioonovas,. slay naco otlsrrbcnlih 5~0si alliliatioo, stir-ic.! polviluaro, sod is

.____________ pieos)uios005. oopatsO ofprafaoaiosol Pesire

[ iooafeaai000l rooiesiuu Sinai npoo poof000isnal rorioso naolaeua_ Mis qoaa~ schon sonnoiso no opplisouu ronbaaedasnr505005relsccalor,sr000iool usotsbmsinipnpaloliauisas,aediootppeasoorasuprnrnepercondaai. tins odssuaoly noreeu ptifmoicual onsietseadsip.probos,co,l noricir tscnbostuiio mAnesiuiosoiassohnenioasf,spfryoiois,omddeu,ina. Mav,rpaamoolseroodtbooo

iomnp,ucn qaoy the NPt5u

Ma oalr-qscu’o ho NPDn 0 sosy lose.

isO Os Ions qo usa thu NPD5 -

Mndicol lanolpnuolicePoymo

f-s sqoonthis noel

the Cihuish car n000ioom 55Dm Gahooamh

C-a

f-uC-,

rerota UsiJssmL~

Ovenicw

The t~IPDB is a rssaarcrra anaitt Statelicensing hoards, hospitals, and otherhealth Loam collIEs in insraieating theqnaliracatisns ofotie health carepractitioners they seth to liceitse or hire,oclasshemthoywisia arrant etembeeshipoeclinicat privileges. The NPDBdisseminates certain iafneotalian iseligible entities on medical naatpraeticepsymtcnlu,MedicacnNedicaidoxclssioss.adverse treasure acdans. adverse clinicalpuicile_cesoetians. ard adverseprOfessional society rnnensbeeuldpaotiestsfee physieiusn, donatistu. and other healthcure peactilinseos who sac teeniest orotherwise anlltarined bysSlate no presidehealth care sirvices.

o Hoapilatsnnnalqnelysclteonpractilionso applies forpoisilegesormedical stalfmitaslsernhip and cvcay 2years oil pmclitianets Os nhentedicalitaffor holding privileeos.

Other hoalnlt cats entities. iectndingprofenuinnalsocielieu.mayqnnay‘clien tittering naemplovtatcnt oraffiliation relationship with a

is cOtsjuscliOO nn idtprofessional testes’ acnivitiet.

Statelicrnsinghoardnmav qsetvalany Lime.

• Healnhcotm practitioners rna3’ self.any nime.

a Plsiatilru aoameau naay qaet5 ardorremain limited cnceamss airees. SeeNPDH Reatalalianu §60.1 l(a)(5) carfable 0-I. Title IV ()nea5 hipReq nears, o’t page 0-4

‘Medical toolpmclire payers flay 001quenyat ally rime,

Hat pilals

Hospitals ase the snip healnll cane estininsnvtaho,aadstosvrsqainemrntsforqssrsyinotha NPDB. Each hospilat moan requestiafanamisaa from theNpOta as follows,

a When a physicia5 dinilat. orotherItoalnla care pracnita’aater applies farmedical uladfappointnosent (canoness orotlncn.-ise) or foe clinical peicilegos Itthe hospital.

a l3eny 2 years Thiemsislly) as allphysicians, denlists. atod other healthcite pmclilioneas ‘nba are on lamedicol atnll(rourlesy or athens ian)orscha hold clinical pnivileres anntreInospisal.

The btemtialqaeox nasaylnedaminaccordances. ith regalar medical staffretppoialmrnt and clinical pririlegoaedelinseatiots. Hospitals are aol rcqnlrcdlnqnaeryalore than oneeeveny2yearson a praetinioaerwho is emalinaunasly ensalaf~ Ilospilalsavi. Ii anita’reappninlmoal are not reqnlred La

Its. 1-lospitals nisay query heNPOLS oc any nttase thay wisitwith cespcvnIa prnfessiacal levies attivtl.

Hospitals are also ~qairod leqeerynhe(FOB when a praceilionerssiahes Ianadd ci oreapaud enisling privileges andnehen a Inraclilinuere nlaaalls anappliralinu far iampara~- privilrgra.Fsr csnntple, ira praclitionerapplias farnempotary clinical privileges fnnrtimtsisase year, hits hospital most qasly nutNPOB on each oflhose four occasions..4 hospilal is roqaired to qaeep the NPDE

each lime a tocsssaresteaisptacst’tisorrmakes an application fornoarposatyprivileges, not each titan the peuctilionereoatteslsnlte facility. Toeedace the qaetyborden, itaspilals than Ircqarnlly usepacnicatae Ineom resentschoose so rppatnl oath peach tietteesrotttcireoasallasl slaffor olhee appropriatesnalTealogocv in accordance with theirit5 laws and then qacty en nhenn achen theyquervonstheirfotl ntaffhieaaia

Honpimis are roqnired no query enserocaosy staffcoasidered pass aminensedicalstatt even if afforded only nonclianicalprofeasinnalcraasess’esofdte medical librlryanid continuingedacanisa facilities. Ifa hospital extendsnan-clinical poach cc cournesies williammost appointing paactiticnets to a medicalshaff category, querying is not required anthose peacdtioncts

clapa 0 l5maiea Nffls Osd.bask

MANDATORY QUERYING

i~i~’~I~ ~≤~:

ttntoenhaflhttnt rn-I

NInlncasidehoak Chanstoo Q.c,icn

Ronidcele and Interns residentts er istema ssheo such intdi’idaslaureappoaacedlothemenh’neat stall or

Healtin cure eatilies Len nat reqnired In -sted clinical privileges no practiceqareyt he Sx’PDB an niedical mad dental onlaide the panutoclers ofttte formalrrnidccls, intcms, or stuff fellows medical education poogrean (For exampl~(Itauseslaffi, event thoneti they ace often mtonnllohniag inn ti macnaive care Isnit orlicensed. hecuase they are millers is Emergentcv Depatuseon oflhat hospital)smnnataredpraorams efnapen’iaedgrudaste mcdicut edocanian, rasher than Pmre,sinnsl Snclellosmembers of lit c Os ed iran staff.

Professional societies that mml Title ~5Tiserciss a dilyoreocs henwren the eltgihitityneqairemems may requesthoasn.nlsffoflhe clirical facility betpsnaring is fnotstatian from cite NPDB schentto ho furman edacatiost ptneom and the scoeesiegapp liesnts fornssnmhetxtntporhouseulsifrotating loachintical faneilila- aflitiaaian an dinn snnpporn ofpsofcaaiontulpmridingaclinicut ltuiniog site far tlse review uclisilios.fomsal edocatioral prsgeam. Hospitalssam ant ecqairod a qsecy the NPDB on Sluto Licensing Boardshoascttofl’pnociding sersices as pant oftheir formal chiotea ledacatics. ttossescr. State lieoessieg boards mar requesthospitals are roqaired to query on istfcttaahion frum the NPDB scatty

OPTIONAL QUERYING

~S

ceoasnsaaacnt na-a0,5

Caeyse000niseNeon Osctejasca

Types of Queries

Tiile IV of Pablic Las 99-660, lie BenchCart Qotalftt’hnprea’es,jor icr of) 986.55amended. prescribes iho following types or

Previlegiag or Employment: for onebyu hospital nrorhnr healtheerily, lintladice a prnressionol society,

hen scereniso applicants fee nnedicalslaffappotoaoentoeaating ol’elintcut]priviieees.rnernheenhuis. orprefcssioaot ntnltiaiion.

• Prntfesnianal I5evirw Aeitntl~ faraseby a hospilal or ether heottb carsentity, incladisgnptofesi ionat sad clv.sahen conducting prnfesiionnt review

• Mundalntvz-Voae, forest bynhospital when oobmiaing biennial

en physictnns, deniisns, orother health cane pnaclttioners onmedical stafforto sshom clinicalprivilegra have been gtsaled.

• Slaneticensirgttaard:forncehySlate boards ofmedicalcxanninern,Stale hoards ofdecnisoas’, or other Stalelicensing bodien.

Attorney Access

A plaintifPs attorney nra pttinni IIeepnescothsg himsetfoc heortf ispernmilnedlnothlain inl’nmtslien from theSPOts carder the foliomicg limitedconditions,

• .4 medical mnlpracniegatlicnorclnimcost have bees riled by the ptarintitfngnioslahospio linta Stale orrederalwont or olher odjndicative hod0, and

• The nnabject as ssine’n the tofornianicais reqaented mast he nosed i’nnheaction occlnim.

Obtainine NPDna tni’orcnanioaon thespecified oshject in pencilled only aliceevidence is onbrtsitted to tillsdemonscnaltac 11111 the hssnpitnl tailed Iasnbmic a nsandnnoty qseey IS tao Spoonreb’aeding the snhjecl’aanied by theplaintiff in nile ncios. Tidsevidonco is oatavailable lathe plointiirthreaoh theNI5DB. Evideotce nhnt tht hospital tailedto request information from the NPOIOansi he obtained by the ptnintifffeom thehoopinnl ihansglr diseases3, in the ticigaticnpnncnss.

A plaintiff’s attorney nina suhinit oil rfthe fnllowing 0 the NPD1I:

•Aieoererqaesling nathonimnon anobtain information.

Stipporning evidence that the hespitatdid nol makn a nnnadonniy qncey to hanSpoil rereading nbc sabjecn santed bydin ptninniff in lhe nenion erclnim.

Ideanifying tnl’nennatlon ahnot thesnbieen on whom the uttarcecnvioheoID qnen3’.

Ctaplnn D Oscdm

Exnmplro ofestdenee slavdcpostitan, a fnnpnnae laneialerrngarnr~’, and odznisni nn of otheratnidenec ortlie fadS see nra hunpiral coreqnesi lnfornanlinn. The plaintifi’sattomcvnntannccbmil n neparole reqsenn foeinfoennacion disclnonre for each ntnbjnctnamed lathe rciioo or clams.

The approval sea ptnintifrs attorneyqneny is limited taacne.iime.onlydinctosuret abe approval cfnncha reqnescdoes nnt anaw a plaintiff’s untamcy noobtata SPOB innl’onnaatton en a cautioningbasis, Sabneqserl disclcnsccs 0fNPDB‘nfeemntionareqnire the plnitntinrs altorgeytoiltitianenncwreqsesi.A feet’s assessedashen the SPOIl disalenea sneininfoennakois.

An approved qnecy cenlaest ennitlei theftaiacitits attorney IC receive only thatisforonetion available is the NPDB at thelittle the hospital ‘sans reqailcd to qneny batdid not In also incladea tnafocnsntion DII

any repoalo that went snhseqeernty s’oided.

There ant limitations on ihe ase csfinfoemaniart obtained by-the plninliffin ajudicial proceeding. Spccttieollv. thetnfomnntioo obtained trots the SPOIl onthe snbjecl can only he nsed with cenpeelton lenal edits eec lainn seaman nbchospital. nni against the nabjece. Anyfueltaer dinelonsan oe ate. lalanen thecenfidenlinlino pmsistnns ofTttln IV, andsnbjecna the plaianttrs attorney and’nrplattnniffnn a civtl mnneypcnalay ofnip IDSt I .000.

Defense aaomeva an nol gccnnitned accessto he SPIJE sacdec Title IV becense thedefendnscnnbj ecn is peeniinted no self’qoety’ the NPDB.

Authorized Agents

Eligihtr entities may eleen In have ananninctized neent query the SPOts an theirbehalf. An thociaed neecnsmant qccly tsarNPDsseparaiclyen behalfcfeactseligibteenetny, ThcnenponseconntlpDilqscny nnbrnitned for can ontiil’ cannel hedinelnnednonnntheeennirv. rneecreinformation oa aaihcrlzed egesno, ace pacein-I.

Submitting a Query to tine SpOil

Elgibteent’ttiea prepare and nabstitqtlenies using nile Inteenuned Qceeyinr tndRrpornint Service (IQRS) aten.npdh.hlprJh.com. A 0010, a 05crID. and a naiqae pascm’ocd are nsed byeligibtnentill’es and their aalltorized scentsIn repels and mtries’e qoety responses vialine World ~~eide Web. Internet eecnsnaiIm a web beossner is eequicgd for asitac

tIne IQRS.

The IQES does non accept an incomplgteqnery (one nhsni a missing reqnimdinfomnaniotn or is impnoperty cenpieietll.Seth querIes are rejected. Entttien areeecntraeed to gather as rnnch inilirmattonas ponsibie as pals ofthe applicaninenprocess, to make the eampteninn efahe

Etttillesnrey submit qeerits nsillneleciconie toansacnion tile tthtnnission, alnolcaonna rn nine lCD Ttmtsfer Peotenon (NFl.The IT? to a pregnatn that nnanrsmitslaiceface Connsoi Doeament(lCD) qaetysubmIssion flies and receives qnenyresponse files fcnm lbeNpDR’FiIPDB.All data are naaasmtoed overall innmrnetSeenee Socket Lnyec (SSL)tocnecttae,Sebalnining quenies sang the IT? in antalternative for those entities Ihac genceate

TableD-a. raiie IV Qnen’ing Rrqstrnmenrs

CNTITh’ REQtOREOIEt5’T

Florpirnin

Screeategnppllcaeta footsedinet staltnppaislansme nrguatin1 nfutinic,sl htneqnera’psssieces even,’ lames fuerlstsisna,m, drntiatn or ether hndth mtoproelitimens as lao medtttl sinlrnr nnanned clinical rtiutrees

At othee trees on they deem serenely. May qseoy

Orate tterartau 000rnts (tnolndtne blodiorl and Denrala

Whm h,0’ dmo nreee.lae.Only qeoty

Ounce lleslrh Care denIm

Screenine epplicoaa One nnrd,eat alntinppo,atntenr. memheeship no May queryaltitanoa, or dentist efelianirnl peisiieoes mpponhin~ poerrssional

I’eurrsstnntn Snelerten

Otnenlint applieaotn i’nrn,nnbesship no aosiionieta; myosnuhac May qnlnsyp.nfrslimaele,sinss actisitiet.

PlaInt Inn’s MInes era

Platstn fl aemmey er ptaiari rfneplolantung hinnelfue hensetfs,hn hat Mn’ qeeryOledansed,taa nntpesnliceealimosctnim in a State or Prdomt mnnnentharadandironll’e hedo rgniontahmpiuai a hen nvidenae is nst,lain,d IaHOtS sohidl ee’n’mls ha the hampitat blind a make a neqsined qany ofhr SPOD no the prectilioamtirl rito nanond is the necionceeioim.

rhystetaer, Deni lnla,eed Other health Care Peaettttnneei

Recandingtheirns,e tars nanao qany

.‘aledleal Slalpeaerte. Proern Mny non qsen’

nsa

a Setf.Qnen’: brave bra placsician,denltnt,or other health caereProc

a Onher for nut by a pininnili’a attorneyor the Secretary’ ofilitS, an eanhceizedby Title IV.

viva Gaidnieck

Saooeohnnzml ta’l

aaron Oadatta,L- ChmOar 0 Qnoarr

qancies Ire at cllnletn (nitird.paety) tar other Qecryint Thrnnneh en Aniirorieedapeciai pmposo nafiwore. Enthmes that Agenteheotelo query via the II’ Prnnsn providedata in lhe fomnst apeeibucd in itt Spoil, The SPOOn response nan queryHIPDB Jauearftsco Coior000eenasnesl 9(D) ssbrnitied by ott ocnhoeiaed agent on)‘orotaerj’ fl’naiancot’ons. lnfnennvation hehalfofac enniiy in based Opals 590abort qnersintn via nhn ITP is osattabie at eligibifilvatandards: (I) the entity mans he‘a-nov innadh.hapdb rent eatinled IS receive the infnrrnst’lan, and (2)

the sgeenmest he aa-thatiaed to receiveEntities tInt oat anthaeiaed and registered nhat infancnti en on hebsifofihat entity.Ia qaory bonhthc S]~oB nod the tlotlrthenlntity nund thengenanotosi behieattheaee t ntenriny and Protection Data groped’ regisineed with the SPots prinrtoBeck ~lPDB) m oy eieetna quecry holin the nothoriaedngenfs qsnes’uabrninstntr.Data Bank‘a nimllttaneotlsty 55

qtuery snhtniuioe. Enlilien slut ss’ish to Asthnrtced 0genta cannon olcaqseeyqactv both Data Banks should indicaae this nesponsse oIl hebnifoftnaorc Uton osepreference an daeireonrsfaReglsrnneiso entity. SPOB regnietinarspecirv thnirorav inform elton received from the Nl’D Omais

be used solely for the psipose for ssltich itEqnlpn’err I Needed en Query, was provided, ifnwo dili’erenneenitiesEleelranlenhty desiesate the son ncathoria,ed agent tn

query the NPDB on their behalf, and bothReqnieemetdn forsnina the IQRS can he cnna’nios wish no rcqeem ieformanion on slatbend on the NPDB’HIPDB ssrh site, os one anlbjeet, I Ite authorized agem mostItnnitinn louts utenile appeopriate version qoeey the NPDR sepaeoieiy no hehalfofefcithcr Inlernen dxplcreencNetacnpe each entity. The response ton qnenvComnnonicanon no qnely the Spoil, schnnihlgd berone eslils’conarnt heEntities can deleemine their bro wore’s disclosed to moth cc easily.versina tnmhcr hr stanoinellngirbmnssnr,seletlong Help from the ~‘allege)~lims Qirery Processingteiect’mg Aboot Cummantcaior cc AboctInleroen Espioncra as oppeopdann, when the Is’PDB mteines • properly

comptened qsery. the information inYou aisa teed a proonana thatealr reed ecleeed into the t’a’Poscomputersystem,flies is Pornahte Oocnnstcon Enenral (pop) T he compalee nyslem perfoerns(I.e.. fIlm sauniss .pdfesaeno:en), sach no s’etidotien process thot naanches nobjectAdtbeAcrobnt Reader4.t (eelaieher). tie., pcecniltnner)’ndmltfyiee infornsonionDosnntSadnhe latesn vecsios cfnite free saabma‘sled elite queevwith tafoennalionAceobatkeaderon hlepv’oin-n’n’.ndobesom. pmvicunly repoeted to the Spoil.Theta guldel ueesetpiasn the mlslartom Infomalionreponed about osperifloenqoirerttelrls necessary noacceosnhe tnlbj’eet is rele aled no an el’tgible queriedIQRS. To illtprosn ns rabiiits’, the SPOIl only ifdne ideaniifv’laag infernnatianreeoamnrmdo that yea lose the moo retest provided in nbc query mntchen thecession ofeath beonvseravat table for ytne alnforlnntaean in a reportopeestlng syonem,

sermnmltol 0-sthe soptehoa2ent

SPDt ucthsooh aonaoutaissL

Each query processed hr tire NPDBeompcteesvencm is assigned u unique DataBatik Cement Nmssher DCX). Tine DCXisosed by the NPDB is locate hr queerwithin the coonpcter system mdiprominently displayed on an elceirosieresponee. lfaqtuention ueisescoiacernsneapanieclac queer, the costLy most referencethe DCN in cute correspondence in theNPDI5.

Subject Isruostialicu

Wines sahmittitigc query, lie entity isrequired in provide ecusairn subjectinfomutioc, The eDO computersn-stem does not allow rittilies to subunitqueries thai do use iodide iofronnsaliunin ill mtndaloiy fields. An entity’s luckiifmundulun’ information dues nonindies-cit ofqteeylog requirements forthe purposes ofTitle IV.

A subjects Social Secerity Numhet- (SSNIshould he presided iftasown, but only if it“as obtained in accordance with Seeliotu 7efthePrieoeyAen 0/1974. which statesthutdiselosere elan individuals SSN iscoltttslan uttless othenrise provided bylow. Disel asere ofan individuafu SSNfoe theputposes ofnhis ptugtaus isvoluntary. TheNPDB uses SSNsonln toverify the ideutitcof individuals. andSSNs ‘sill ho disclosed only as authorizedby the P40/nit Coo-c Qtsotirss Jmptoo’ettreealet ofdSSe. Os ameoded. f~ eitteliuaien ofhit isfotassation ttetps to ensure the

accorate identification oftlso sabjeec officereport.

SnNeei Database

Von naay etnoblish n subject databsac tocompleteynarqaecr.-ieg nod reportingobligations mccc eflieienllv. use subject

database isuteasase ofthe IQRS thatoffera as easy ntcthad formaistamingiufaensstiott about the subjoris on olsomyou routinely qsety Cr report. fee.. SocialSoenriess Numbers. dams ofhieh, licensenumbers).

You ntay impotnapee-caist or QPRACsobjeet database into the IQRS, olimisstrngdie seed to retype ssthjeet data. Forinfotanonian, seethe Foci Sheer on(bearing and Mfsiistioittiog at Stashjcroflureuhetar. assailable at nso,s’.ipsth.htjsdh.eotu.

Chancier Limits

Each field iou qoeey (unuh as SubjectRome. nt/eeL Addrcsu. and LicenseNumber3m listnited tancetnnisa osusiher aleharaetecssitteludiae spaces andplsncloatian. ThelQRS soflscaue daesttot

Ihecotits to etc store than fineallotted otmbee of chauoctees. TIsrNPDBduos moot chsutnge ann iul’ortoaiiunnultmiteeaa lnaquen-.

Queer Respnnnru

In groan I. query eesponaes aug availableelectronically sn’itlein nfl oven-apr af4 Ia 6hones ofreeeipt bythenlPDS. Codereeotaineireumslauees, additionalproeeasiog maybe requited. Entities thansubmit queries using the IQRS shealdreuieve their qnesy ertposses fmm theIQRS. Qtteniestnatlsed Completed hon-cbeen processed and tea asailable far

Queries onarked Prtdisg has-cnat yea been processed. Qseries maehedPoetially Completed reqoiee additiesalprocessing titie. Qanrietmoeked Rejectedhave one or store cleats: they Itave beenprocessed and a deceuetnt describing theeeroe(u) is available or retsieval.

Entities thsn ssbmic queries rio the ITPmoat ~~tern their quesy respotse050ingthe fnle transfer peogemn specified ha thelIP ittstnsnlieon. Ii? rcspeuses atefensanled in the Iastu’eforr Cessna?P4vtsmrsso I/CD?Pr Quay rronsoersossaceerdine to tha aprriftcanirtcs eroticappnssprioee lCD. Subj~ccta who srlf-qttrrvnv/I receive pipes responses scan by ricanClans 1)5. Mail.

When lbe~ in no inFoenura~s ftt tho NPDBabettauobjeut the eutirs- eree ivesisreopossenoaquery only the ideoltfrinesubjres infotmadea pmvidrd in the querycoda notification thaI 00 iafomislioooboist the s~evi ls contained iii theNPDH. Qoetu infenastatirt sssbttiiaed bythe mliiy is tint retained ott subjects fornsltnm heat is to record in the NPDtO.

Eetitieothansnhnin tier fetsersobleetmoles receive scpomlc response files fatetch qutrt3’. When the ossaher ofsabjeccnames submitted is II or more, batchdasstloading consolidates query files sofitatasingle tile can mattia mtltiplcrespoosenand held up to lmreataytrafduo. Moog with the query response files,eoliuiru atso ercoice u list afull die subjectunites qserird and the tile nisnhernshareeach nesisonse is located. ntis list helps toqtictsly ideotil5- the hssaniontofaspeeiftcsuhjeecqaetyrespasor.

Query Rm1usnseAsstllabthitv

Qar~rmpomen are as’ailshtevinIQRSOrITP4 lo6lnoues aflerthe qneryioprocessed. Eontiniea must renrieseemanates within in days ofproeessiag. orthey will hr fatted no re-submit theirqeeries. Enntities that ssish to save querynespoosos shsuld dossidsad thetainansediately and sure them satlieleharddrises,

Ideally. iofamtation (rim the NPDB willhe considered during the eredeotiolingprocess. Fiusssn-s’er. the NPDB tow deeunot require qttruyian etetilics larnceisequery responses from the NPDB befsseepmeeeditsowiththo creating efelinicalpricilcars, hiring, appoinraro lothemedical soB’, innnaoee of lieeoscs, orapproval ofmesshcrnhips. Because tireNPDteissstrufsevemlresossecesforthecredetnialsrecirsv process mtilico mayact or appileotions according to theirosoblis-bed criecria aud info~atietohnnired from otiter sources.

Missing Qoery Responses

Ifyno doterreceiveaqsersrnspensewithin2loihusineodoysrfsuhmissiaaplease coroennlte Nt°DB’HIPDBCastosner Sen’s~ve Critter 10 request aqueovsnsinsn. Please donotresonatnilaquco)on thescbjecliu question,oslltiswill rcsult in dsplieane iuaanontions anddsplieateqteiy fees.

Correctieg Query Information

Iftise tofsematioayou suhetsilned in aqneiy does non accurately identify thesuhjecnoaschsna you intended noyour quota wil lion notch NI°DB eepunsscbndnted with coin-ecu idontifisiogisfanuaaltan. To qtrn; the NPDB withthe proper idei~ lying infoflaaaaiatt codte5nhi~eeLsnbmic a ness’, eoirecslycompleted query to thoNPDU,

Pailitre to Query

Any hospital that does eelpractitioner (I) an die time the practitionerapplies ‘or a pessitiou as its medical staffor for elitsie at privileges (initial orexpanded) it the hospital sod (2) even,, a

s-i soptroionltoit

thapsmDQ.asrt lOOn Osiosissio

years coticeming auy pnctitintneen-nhois tlsasesec, ifthe residett or latem isen its med seat statror has clinical home considered facclisicol peieileoespris itegen ot the hoapital. is presumed to outside of his or her stsccouredsave knowledge ofasy infirm anion pmgmas5 the hospital must quiets’,

eeponird Ia the NPDB concerning the ‘vi one diatniedi cal malpracticepnnctitisner. A hnspitnh’s foilsee so query paymeals nsodn no belsalfofand00 5 pmcntt ion-er any gicea plaintiffs adverse tieenssre ardaus lakes agmoniattorney re plsiul~tftrep~endae hitosrlf residents and ioiems most he reported,me herselfuecess to NPDB iiifornnaiiononthoLpnctieionrr far cue in liticatian 3. Is my hospital required toagaInst the lirspitsi. alt of nor osnes?

Quesil onsun fi Afls~o-en- I fao indicidml helougsno IhemedicatsialTor lists clinical pflsltnnosotyaisr

I - Should I query out he members or hospi’talond if duo iinndicidanl inmy hoipital’s Allied Health licensed or otherwise ncthoeizedPractilluuer Starr (either rmislcred or certified) hr

Sole to pros-ide health earn services,lfthe Allied Health Prociieiouers ore the hospital is required 55 qonos assgranted clinical privileges urnaedieol thgtiodividssal. Essniples ofuucoineshslfmemheeslopyes, Porcssanptr. sofl’ccha frequency are gneinedifyoor hospital ermils clinical indiridsol privileges cad meendospnivileges to nurse praceiuioners. von definilinsmty inclcde ceoiified ustosemost query on them. Each hospital anesthetists and nurseerust detefinine. hosed on Soie tossaod Os” to own by.lanss, so-tsinh 4-kin hospitals r~tieed en documrnnprantiti unecs am licensed by its Sore atdmaiuta’iu recordso! theirtad eredeutinled as poet ufthe medical requesuo for ofurmution?stssiror granted clinical peirilepoi.The ‘mteel 0 fnhe alsisse into require llnspita In ocr nan specifically nequinedqsteoytigesnnedinal slolTnoesnhrrs or b0’the NtiDBis iseplenaenningpn’viteo_e holders suhu ace individually regtilotioos to doso.coedeelialed b robe Imupi nil,

5, lIon’ lout should2. Are hospiuots reuluiresl no quervilie temp query’ responses on file?

OO’DB ott iutrdira laud denial inuenusand resIdents? ~5thilethe NPDB reralotianiareqoire

hospitals ta query the NPDIO, they doNo. Since iteems and residents are sot specify thoc queryrespomes hein’ sees inatesgelured programs of kepson file by requceing eutitien.cupenmued pea duane medical education Please none however, d st hourand are non(geernally) menthers oftlse respocsemayhe tsed as praoftliattidiest sralfia a formal sesse, therein your errasizatirs qseried the NPDB00 taquiremecn to qaery on them, on the practitisoers.Hospitals may choose to queny fit

residents and intemo ifllu~’desire.

n.m SniO.onhnneOl

nspsnisn1tni 0.5

srouerthluok cnetsn-tao,cu’oa

6, IfI cannot fund urdid toot remit e a liquidation. esm under u debiae’ie’resp005r to a quen’e tuas lrequc’ata possession, it moo eonnmnoe no querycops’ from the SPOB? the NPDB. fit is in liqsidanioo

sold’ foe site porp050 ofsele ofassensXe, The NPDI3 cutneotly does tins and there is so esoring huni rest asshose the copohilitytopredoce hospital. there is no teases ho qeetyduplicate oespoaies. If you did oat and your DElta isitl be deactivated.rereive orerponsenon qeetysmdssese Youeorganizaniooisrespoosihtefoenot charged foe the qisens. the query siotify’usg the NPDm ofyuor stasis, Ifhas net hreo processed by the NPDB Ito hesphanl cc mes aider ue Sraisd should be resubmitted. Once 05515cm hip, i heoew nun-re trustprocessed by theNt°Dt.o, qseev reg inner with the NPDB and isrrsposses still be tosi idshted is the responsible far fulfilling its reportingIQRS fer3n days. Alber inthan, due and qiieryistr ohlipasioccrespoitses will be deleted feom sitetQtOS and the ensly will hove to 9, My hospital b to Chapter 9resubmit the qurrytoneceive a tauukrupncy’. Can ireonliune 00response tfanu did isot receis’e a queryu he NPOB?reopeusesnuquers bsstscereehsresedfrri I, see the Mioiu0 Query Yea. Ymr hospinol ssitl he chargedResponses seenian in this chapter of foe any qormies sit hmi ned 561cr thethe Gs/utirbsck. Nptafleeeeisessutieeofihe tiling of

the Petition fsr Bonhnnpncy.7. Maysetf—q ueetes tag used to satisfy Oeguns’r,ati cnn dint hare an obligation

requirements roe peer res’less at d to qoen’ (i.e., It ospiots) must stiltenaptsymesr? steen tnseirqoei,ing obtieatiuns.

Subjects stay sItar ruse to focamsina tO. hIs’ hospital is in Chapier t Ir esloited in their own solf.queiy task ruptee. Can it ennui’tueltesponseuss-ith ashnioever they query cite NPOIO?choose; hoseecer. such shsserdinforntslien duet nat otisfy a Yes, Your ornanizutina stilt hehospital’s legal requieenteut to qnieuy choreed far any qtteeirsiuhmitledthe NPDB ssheeevers physician. alberthe NPOB receives eunice of thedens~sLernther health coon feline nfthe Prlitinn fine Banltoupley,potcddoncrappliesa fnrehisiessl Otamanieoliens thantove an obligasiartprisileeesor omedi cat saoff to query i.e., honpioln) otust stiltuppninsnenn, meet their querying chit’gaolona.

I ‘My husplist Is In Chapter7bauhruputs’. Can in eoutissr inquery’ the NPDB?

tf’oerlaaspital stilt has oneninebusiness osd is funelionisg ashospital while concluding its

aop,anbneaesi cost

ctnolno It Oaths. NcotoIa..sdsbasL tSptta Oathossh

II My huspinal ban icon liqisidaled bythe Sunte. Can it eoniinnr no nlnc~’nbr NPI)B?

fattir honpital nih has ongaisybusiness auadiafanciines’iognss,bospilal vsl,ile concluding ashiqoidatlon. ii man continue to querythe Minis. Oiice nlie liquiduliau

is concluded or youroi5anizatios has an ongoing businessanahonpital. dicer is to reason noqtirivand your 0010 ‘sill bedeactivated. ‘Ooiarorganiaaoira isresponsible fur notify ing lie NPDB ofits onIon. lube hospital conies undernow ewnersisip. ibe ness omiermusngerisier sills tine MIsDO nod isresponsible foe falttllirg its repentingand (serving obtigaduss.

2. Cnn I dcsigaane ni Oi0 ban Gnuaaiburieedsgenenoqnenriarennahnspilal?

Yes. The MIsDO cmsplitersyuem eonnuwnccnneniodaiematiipleanlhoeized agents for ouch querYingenlity.

13. III decide no dooig,oaiennanllnnriscni apooi or change fromone agenn In nnanher, ho’s long “Illit noIse hcfnre the aathsn’eeilugeunncan qneey for my lionpiisl?

1101° aathorizud aural is sunnilyregienreed isith the NPDiO and hasbeen unsigned nDBIO,theNPDB ssillseed nonliacacon docosients is yourorganizaliun cod the .inlliorized scent.You should check be documents noessuig that all infnnnnation is coercesYour unthnrized ugeut will be able noqeely on yom orgnoizalion’i behalfimxnedtalely upon receipt of henuiip’seal,on dacunieeis.

Overview

The NPDhu nots primarily anallaeeingsystem: its principal pniepole ~5 10 facilitateaeompecheaisive review of professionalcredenninls, Isifounnianion usmedsealnsalpenuliue payvannis. curtain udverseiicensnreaniiens, adverse clinicalprivilege ncni000. ndvense professiooolSociete membership octions and islodicaeejMedicaid enclusions iseallected loon anddisnemisaaned to eligible mutes. NPDBinformnuion should bu cousidened wilhother eetevaisl iisfomioiion in enaloalin~ aprseeiiiese,’ncrednuhioln.

1i0 iSle entihien am eespous ibte furmeeuing specific (untying undue reponuingreqoieemenls and nsusl no3islee wilb heNPolainorderlo qoeiyereepnmnissthe759~00.

The infonnoilnu unquined lobe eeponned iothe NPDO is applicable uophyoioioas,deulisin, and, its some easa,u, 0111cc Itnalilicare pnoriinionugs who nit licensed orethendoesatlioeized by a Slate no pros idehealth core scivites.

Time Frame fur Repnriin g en ihe Mmli

Mandaled NPDB reporters otusi reportmedical malpractice payments andadverse aueioins iulsen on up sfterSeptember I, 1990. This in lie dalelie MIsDO eoinmteuced epenalics. Wills

the mcepiion ufeepoena os MedioaeeiMedicaid i°.nclasiani. lhoNPDBcanine aceepi any report svitli a dane ofpayment or a daie nsfueuion prior toSeptember I. I clan.

Ciril Liobilily Protection

Thc im,nonilv pinisisinsn in theRcngthcorc Quoalio aansilniptoscineon Aoloil IPtd protect individuals, cntil,us, andtheir nulhoujeed a gals loom heiosn hgtdliable ii~fli foe repoens made tothe MIsDO unless buy have aeniollca,u’sindue nf family of the isfeuanatann.11,t ranate presides die satin immsnily ICOilS in mainutni’ig die 5iPDB. Fee mote

on civil liabihiss prelernico,rcfrriu page A-2.

Oif,eislsni’gange

The MiDO’s official language is licglidlMI repotns omit be nehtnilled ia English.Files snbniilled in nov other laeagnagn orcontaining nnn.atphaaiumeeic ehuraclurs(e.g., lildun. atcenta. ursbutss ann nonoeeepled.

Cnmpaiaiinn ulTinto P0,11115

In compolinc uny period oflimepmscnihod or altossed by the NPDS slatuneor ceealalitnt, lie dane oldie oct orevernin queaieo shall oat be inetaded. Thrdnyfolto’sing lie date oldie set or rsenlinDny I for pmposmn of computation. The

day afilie peeiod so conuputed shill heincinded. Satntdays, Sundayu, nod Fedutalholidaya are ma be iucladed in theenlcctau’onofni mo periodn. Hosscrec. ifthe nod date for sabmitling a eepanl fallsaol Salceday; Sunday, or Federal holiday,die due date is the nest redeml work dsy.This uttethad olcelnjslltalioa of limepetiodn is cnosisigntsvith Federal Role ofCitilPIesedaav I.

5511 se9aashseataal

ransom cruet XPsliOssnbnsk

Table Eat. NPDD Reporline lnoqnlcemeuis

~ Usd15 Piivnlcannnisd COne Ileald, Care~_______________________________________________ Demtfnin~ Itlndinal .‘lnhlieainlee Pare, tail inpoon aeaiiinpasu

, russo, moalung goon snium tluo setodipraust Ilapoe,msslbi nubnuiuedothutseratnusdappnnpljaie

aloe Il011tino haand ‘sidlin an dais me. Insumit.0,10 Luomnlor uaaoda Moo, eopau rosiest0 no enscilinul.tumneno dineipii,ans anton hound en inasnon nol,Iedis enqsiin’notnn

, psrfensional aasspen000e I’ asndac,. nnpselnnae benuhmiied Is iaio ts’PDn aidiin 10 dcvi erthe osfunilasplmataaud Olhnr iirailh Core muss., ‘tout Intact kin0 mplsiPtoressinssteass’i,n,euian.banodonoanonnmlcndb

~ rnofenuionduanpniananeeesodusvod,sisolyalfeu,ise~ sliniuslpdsilepeu faeapniisd l000goetlian 10 dannu or~ scIons0 nuemenderon usosinniot, afcliiisaip,ioito0oni ohS In undae, no no ,suisi. bswntnatsn. Repass moat hr

nsbnatnd an iho yaPon tad appnupdntn Otain liueati,abnsaadnithin Ii dassafiheaainn.

nansiun,hanedensuncenntuuioe,a isis’ eopsfl ‘i.yeepein- pmfnosiandusao penuece or candsan,udrnesaty.lfns,ioe; nsanuhseuhip. nepo ii, nan to nubadmed u lisa ROOm; aad nppoupeinte 0010 Itoonsion honed stain, to dan upF Or uaOan.I OhIO Omrcarinnp,snae Cnneonl Stun eap.i,s hhsanrpcenI Esciosina besnModbaidislrdionneondudseeyedoaslI puonnans. Esulsniea, a,, nnie.,iod nsan9i~is.

Submitting Reports to the NPDB When Snbjece enformanian In Unhu,o,na.

Subject Iinfnrnalion As ‘tndieuled preciously, tie MIsDOculmpanersystem dons nit nil one reports Ia

When aubmtuing a report to thrNrDB0 be sabnttilled nsill,oat all mundntnuythe enpomning couity is required ia piocidn subjmm ioformuhio,,. The MIsDO suggestscccliii subject inlanmalion. The SF010 clint each reporting ennilyrrniess dig

eennpoicr syseem does nut aiimvrngili~ otandsiei fields infnnsnaiirn and ‘nthe onto sabn,il reports that donnnlinrladr etl’anto collect this information forenchinformunian ill all mandneurv fields. ctji prachtioncr before there ls000uae to f,itrn10tvs lack of niandatney informaniozn 5 report (i.e., daring the applicaiinadues not relieve II,. entity up reporting prarcos). An incani phone report (one Ihatreqairemrnos for nbc pnr]soses ofTillo is missing reqnaired i,d’oinnslioo or inIV. All required fields in a subjects ianptoperty completed) isnarorenplnd. Ifmcard mart be compinlndbnfnrea report yol ore taring Foabie filiag youreus be generated. Enmities ohna’idprovidc nlecieos,c report, pleaseconuactiheas mach iofttiuauiou as possible, ecesin NPOB’HiPDB C,,siomer Service Ce,,ler.thn fields nhnt ale sun required.

Snpsnto ntOi 01

Scot Gnia.h,vk Otofas C In0moo

Rrpurnisg Snbjncn Social Secnriny’ isssau.’tpdb’hn)edb.roaii. Dare lugged ontoNannisera tile II hr. the rulily may euler and submit

report infuretalt en in nbc MOOR.Undm Twic iv, 0 oubj oct’s Social SecurityNumber (SSN) shuald be pravidod if Medical matpmcltec paymertuiatosvnss hteo reporting medical relied lied using the Medical Mtlpraenieemalpaas.‘tire pa3snrnns a duemse clini cal Papinent Report (MuIR) loon’s Clinicalprisiteges and prafossional son coy acuiono, prisileten. proftssional society andhal only ifeblaised ia seconaunee wihili Ileennuac uctionu. as ‘sell noSeclies 7 oluhe Prj,ocn 4cr of 2974, Mrdiemrthtcdicsidetell,nieonoeowhich perot des than disclosure ofon sah,nisod using lime Adverie Actnnnlidisidnal’s SSN’ is volanlasy “ales, Repeal q.&slU farn,al.atl,nnsise presided by law. Oisrieoupe ofan indiridoal’s 523 for the purposea of Both tl,e MtsiPR a,dlbe AAR feni,anshrIhe Nl’OB isvoluolatv the iQitS eapiure sil uhe ueeeseaçn

infornnalion for repcgisohsninsiun.TheMPDB wilt nse SSNs osty iovenify Suit’,cirnm space iu provided hut the fields totite identity nf’aidiciduals, and SSNs ore allawentny ofmahtiptn prunmit’loner lieeniedtnctosed onlyasnutharized by nbc Heslal, nambess, Fedeml 0mg Enfamcmest(‘an’ Qouelil)-iospon,,’cmemAcgofd9l6, as Adsnninislgatas (DEAl nuanhers,amended. lIne ,nrinsioua aldus infoena’ ptafessinnal sehno,ls, und hospiisitics, wherever post ibie. is cotrsunu5ed affhianons. The tpicsnllonvs rora 2.000’bees use in helps no ensure the oceunuie character desceipnioss ofthe ncls noideniifteumicn efthe sahjececsfthe report. canissians assd, i ,tihccaneofMMpgs. a

description ofthejudemest or acmnlnmgnmAn 555 is ren]ui red For adrert.n siuleniouls.licensnpe actions, ns these repo resalealso mandated for inrlnniun in the Subject infonnom’ton does nei nerd Ia beHIPOII coder Serum. MISS ofthc reroieeed into a report ‘annual if an esnil)’SuelolSgcuirioyAel. Section II2SE maiclaio.saoabjeet rlaiabnsr no the IQRS.requires than SSNn se pranided as urn The IQRS remsirvesa II peetiucalofnhc rcpurlinn procrsn. iufnemaons frum the eolity’s snabject

duuabase into the opgsropujanrceportIncorrectly Idennifird Subject screens. hsosvesev, ifa rceond in the aohjeeu

daishaic is iiscomp gte (i.e.. irlarnsatiou islfa,i ealily rrpomos infaeas,alion for Ihe missing in reqaired fields), the 1Q95 donsswung subject. the reporting cetiqi musc mi ilium a report robe genemaned fee titansubmit a vnid ofulue incorcccl repoto and subj‘net until the missing mnfotinanias iasub,nita new initial repera for nine emneen added. Por mare t’usfennnc,tinn en sobjeetunbjeci, See page E.5 fog more daunbases, seethe Rum Slice, no, Ca’eoaisngiufcnos,dau es Void reports. asidM’maistui’thngosn’bjs’cprsalahaoe,

asuilable at snoae.tgoeth.h4eGlcaesSnbmimeing Reporns Via nbc IQUS

Each daia field an the repent inpn screclusEliemb lucnlitcs stay pmparr and snabsuin islimited lou certain eaaiberofreports ssiog din IQRS at ehauaeurrs. including spaces and

Oopiamtn, 21111 ni

C pt no C Ct po so5000 Otsrelnast Clots? E Oeroria

punctuation. Peresmtple, the erorrativedescription rields otlow Z000eliaracters.iocloditre spares and psracooation. Anycharacters overi,000 ore Urerculed.Doling your no adre in occordosre withthe character ltmtrs wit aveid,he seed acoreeclo imitated naseotive once thereport is accepted by the NPDS.

Upon subnailltoe the report to the NPDII.wilt receis’eo Te,rtporeev Record

ofsttbnoisaiioo tine onset withcool,rooariostronber. The renftrnraoiontsmnbcr car, be used Ia verily titan ritecoolly sobrnoittcd the repeet, Within 4 to 6boors ofrerript, the NPDD witt etobeoroilohleooolreecpartingen,itc on officialRcpr,n Verqinotieo,, Docueerort. Thereporting enliry most verify the report dataen the Report Ieetiroticn Dorooenrrtt nodCorrect all)’ rovcl,eoos itolrmtotion es-trite.The subject ofthrreport “illCOPY niche submitted rcpoet h, root! fretsthe NPDti. Each NPDE repenter mosteat In copy of the paper rrpott to theappropriate Slate ticeruing board.

Droll Capabitilv

The IQRS includes a Dmft report feotatrofat erateriog repott dato into input scoerna.O’er. sasitrg tire doceottrot ‘m droll statas,Thedraferersie,ooforrpceneoo bemodified toter. Droll report, may be satedotothelQRSseesrrforamasimoets ofifidays before they roe aolsoaaticatty detened.Reyorts saved us drafts are ,teteonsideredotrtctal report subtnissietts. Dolt reportsmolt be compteted. sobmitted~ nodsaccrsstiatty processed by the NPDO tofotlrti Titte lv erportine reqoireosetrto.

Sohotioniog Report, to he 01008 liiIT?

tb repoetinr entity does aol hose accessto dte IQRS. or prefers to geneeote reportssainprttstom softsvaee. rtte testy mayehcooe to oobrtatt reports via ott electroniclonsartien file sohmisoiatn thaown us CDTransfer Program [171011. ntis method ofreportirie reqsiees he entire to tahmit dataosing 0 fsmsot specirtedhy the N?DBleterthce Control Documents ItCOs)opecifr the fortnaL 1°c liP reportsobmisaiees ofMhlPRs aid SARa, Thesettecsmeota ore ayailah te so orrsn’-erpdulhlpotb.cem. See pore D’o for totesptoteaaies of IT?.

Types of Reports

IolIiaI Report

The Hess record ofootedicotpaymenloradverse ectioo sabtarilted tosod processed by the NPDB is consideredntte built reperl. ha loitiot repori is thectorrestsersion oftttr report until aCrrrecaioo, SCold oeResisiro reAction issubmitted.

Wherttlte 010DB processes ott Initialreport.. TetrrpomoyRrcordefsrthmisaier,documesiioaroitobte to petotor save unnitthe oltirol Report Verifironim, Domineeris retrieved be the report,‘op eotit3’ fromthe IQRS. A ,Vottfieaeion 010 Reporoor,the ,VPDBvPIIPDB is moiied ta the suhjccl.The reporting entity rod lire sobjeetsttoaldreeir,e the report inboentarion toensure thotitiscoermc. The reportingemily shoold also print atrd soil 0 copy olthe Initial report to the appropr’ole Slaterrcensirg hoard.

Correelisro

A Correction ioochaoge iotrrded tosupersede the cooteras of the curreotseoiotrfareporo. The eeponitrgerttita’51051 sohtttil a Correction or soonpnosihir otter tie diocorrry of on rIver cvomission inoreport. A Correction toy beoohrtittedtotepiacethecmreenn versionofo report as often so eecessorv.

Wl.eo the N PDB processes a Coerertin n,Teo4socrreyRrceareioafsr,Oortsoiorrdocument is oroilobir no prior or once “cliithe officiot R~’rr Vrerjirooioo Orreuoretrinretsicred lromthrIQRS. A ReportReritt’ot I’stiried, ot’Siooee Chmtgettdccoromt is matted to he sohjertaod ottquetiees onto received hr previous versionoftherepoern.’ithiothepaool yeors. Thereporting eoitcy ooid the sobjeel shouldrenew the infrtosoroo to ensure that iii,cooteet,ottd qorrieesoheuldttstetherttottged report. The tepoetitre eolilyshould oiso print and rooii a copy ofoheConrertien to the appropriate Slateliressirehoori

Ittoomptet A horpitat sobmilso eltoicolp000ileees triton to tire P410DB, Upoorecciciogilte Report Veriliroti onDeetatoent, the hospital identifies in errorin the subject’s address. The hospitalsubmits a Correction to the Initial Report.inetoditin the correct address.

Void terevinus Report

A Void is the ressoctirn oforepon io itsestimrv. Au example ofa Void is thereverootofuprofessionairevtetvsetieo.tire report is otmos’ed from tho subjectsdisetosabte record. A Void oar hesubmitted by the rrportioe entity or icylime.

When the NPDB procetms a Void.Teotenrsrorv Record ojseimti ion isaraitebteteptinroroave crtilttreofuiciatsaid rerilicattero is retnieu ed frost theIQRS, .4 Rrporl Rs’riseol I’eioterl orSr.aorsCheangeddwotaentisnosiled to thesobjectandatt qnreriersnsttereceivedtlreprecious version ofttro rcpote sarithio thepast 3 years. The reportino entity aod thepractitiosershoatdreriewtheisboemotiento meat th ot the coroect report woosoided, and qorriers olistrid oote ‘trot thereport woo voided. tire repoeirte entitysttrold atso print and emit ocopyoftheVoid lath eappeopriale Slate ltcenstnehoard.

Exumplet at, Stole Mesticot Board submitsno AAR when it rrvokes ophysirius’olicense. Sit rronihs toter. the revocarico isoverttored by o State ecart. The Statet,lertimt Board should oohmit oVoid ofthe Inititi Report.

Revision to Aenio,t

A Revision Ira Aetioo report’ 00 otriot thanrelotesro ood,’or modifies sat sdteeseaction provieotsiv reported to OrrNI°DB.Ii is orated as o second and seesomteocnioto by nbc NPDB, hot it does tot settlettr001igirtil action lttat anus lobe.. Theentity that reports oo initial adverse aetieonttstotso report only rectoioo to tin’action.

A Revision toAceiatteepon should besubmitted foe the fat tossitereosoest

Additioso t soot liens hone been oehe,toroitor tire subject btsed coopreni000 ty reported itetdrnt.

o the trtteth of octiort hot beet estesdedorredoeed.

frI aoveehsoitot

carat r Repro NPDt Goiirbock

e The erigloat soapeesion or reported action, the hoapinoi mast submitpmbattonans period has ceded, new report 05mg tire Renisioo Is Action

option is lire IQRS. The Isitiot report• Lieeostae. ctinieot prisiteees. d acumests hat the trospital sospeodcd the

profeust soot secietv membership, or uohject’sctitoi cot prtciteges. tnd theproeootn poroteipalino hot been Revistot, trAction docotneora that therrioswted. hsspitst madeossbse quest eevisiaota the

action.A Resition Is Arlion should ttst bereported miens the initial action Inns Etotoptes A hospilat ssbtnits on AARreported Is Ore NPDD. Vci,en oubmiltiepa us. heo itrecobes anomlsorrgeonoctinieatRevision to Action, the repa rtee most peis iteees. Tnvo years lorot, the sestrefereorr the Data Booth Conteot Number sorpeotsciio’teat privtteoesoreretnotetcd.IOCN) en the report ofrite action heioe Sittre this action otodit’tea tt,r oeie’molmodified, action, the hospital moat submit

Resisies to Action, mae loitiot report.4 Revision Is Acti en it separate ond docorsettro that the itros pitol revoked thedistinct frost o Correction. Foreormpte. seat sonoeon’s citeicol pririleges, ned theiflhe hoopiioo in tie above esattptc etttcvo Rovioioo to Anion docoorrects dint tiretie Dote ofActi ott ince~ctiy, a troopirat mtdeomvist’os to ih cart’rm.

Correction most he submitted to roobe thenecesrany change, rod the Correction Report Proeesst~ngoverwrites the bsitisl mport. A Rcvtsicoto Artioe istreated us on addrttdomoattte Ahtorn thetOPDB receives a report. thetttiltal t eporL ofoseat’ on is ese red into Itre NPDB

compoaee svsteto. Each version ofooeportWhen the NPDB peoeesueaunterisisn to processed hyttre tIPD BcotepocersysierarOctior, a Tem.roree~.Recmadutf isssnigorrd a ouiqoe DCN. Thia couther isSsbntiuaion doctanient ‘a avoitohte In pritl used to locate tie repott roil bin the NPDB00 tOO eustt’l theomciat Report cnmpater system. The DQ’i isVerification Decrtsoeeo rs reletes ed from promtte‘ otiydisptoyed itt the etectrosicthe IQRS. A Voeijtr050o ojo ReporPits Repair l’errfiraoicn Doesmenr. ‘Die licethe aVPDB is mailed to the sohjccl assigned tar he most current version cftheproelitr‘otter. The reportitse entity nod ntte report meotatsvoyo be referenced tn artyproctitinoec should rec’ cr5 dte informstton sob teqtent ocr, ea i,tvote,’ne the report.Iseosore thot it in convert. The ecpootiogentity should oluo prtnlosd moit 0 eepo ol Repord Reap nosesshe Rerrsten to Aeltos to lire oppcoprraloSlate licensing beard. Each time a report is successfully

Example: AhmpitaleshttitsroAAR sathrrtaredtothelQRSaadpeocessedbyusher. It saspeods 0 pracutlaoer 5 elmrrot Durcerent in stored for ha reporlineeotityprtrtteges fee 50 ~ The saapcosoo to

ness’ ortten dint mndrf,m I prent005ly

0,0 tepsmior200t

ssrmobes toot to

S75s Ociirss Cerss C Orvorn

eecript. 0 ocn srrscod, the report omipatin ht’tsoine Report Verilteattustnairrtsined on tire ten-crier itt daysbe fore in iso sansationity deleted. Reports witt he ecottubie eteciroeicuttv

nsithie on overage oft era 6 bouts ofEortsteu siteotd printer save the report rceeitrt by the Nl’DEi. l.Itrder certainotttpoc hefcve totomoric detrtiuo ocettes. eireiamntaotres,oddittroot proecsaiop etay

he ee~sired. B clinics thoald not ec.tnrhmiuEntities than subtuit reports via Ott lIP reports en, the sobjert inmosereoni eve thcirceport responses osite th’rswitt rts,tl in dup irate oeports. liyeonito ftte tt’onsferprogrroo specifted is the dssotrecet’eeyoarretpoasewithin 203tip icstntetiens. tTP revponses arc bosiness days et’snhetissies. p teoue mafsptatted ocerardine in the spectocatr’oss the NpDB’l 1110DB Costomer Sen-iceeflhe appropriate Cli. As with resprsses Center,downloaded (rosa the IQRS, eotit’tea mustI’,-nets’ their eepoeoveriltcoiioostoeosore i lyon or’rgital report’ 5 trot processed, thehot the information in repeal and this NI0DB silt eer]sireanesv report. Theecpten efthe verosetsore roai ted to rite NPDB ‘viii proc cot the re port ond provideappropriate terse tr’eersist hoards, you with o DCII. II yoa n—ed to make

choape in thr report. ore the DCN and tirerppesspriste procedures exptoitred itt thisetsricler500kto srlsrit a Crsvectitn orVoid.

tetsrrshon tao Ott

5550 CuiO’k,tsCseoaot taeaaoa

Reporting Medical MalpracticePayments

Each enlily than mao ma payment for hebenefit oft physician, deunist, or olbof

• health earn praetilioner is setetentencof. orin aantsthctica initiate or in pass of, aclaim nrjad6mrnn sealant thaI practitionermsst report the passnene lnfornnatian ce theNPDIO. A payment made as sensatE ofasail Or claim solely againot an entity (foroaantplr, o haspital, clinic, or group practice) and that does not identify anindividaaJ prsctirinarr is nor repcsniablcandre the l’iPDn’s convent regulations.

Etinible enlilies man report when a tampantis payment is made orwlten the lust cisciliple payments is made. Medicalmalpeaclice pa3ineota are limited 10exchanges ofmrney and toast be Oar resultof atvrinlen coinpluinl or claim demandingmonetary pasmesu for damages. ‘Thewritten complaint or claim must be basedenupraclitissner’s provision ofor inilareIn provide health cart scevicei. A striiilencomplaint or claim can include0 bait is getlimited to. the filing of acaaseofoctiaa

based on Ihe last of Ion in any State arFedernl cocrc or other adjudicative body.atelt ssactaintar arbitration board.

Triccer Date Far Reluotninc

Reports mosl be sabmicted in the ?s~leDBand the appropriate Stale liceeaing boasda‘s-labia 30 days ofthc date that a paymenlis made (the dote of the pactocot check).The repors man he submitted regardless ofhate the toanler was ‘mInd cfnr iastance,coonjudgmocun, oos-of-een,c neittescent. orarbitration). The 30-day periodconlmeeces on the day following the daleof payttlentt.

Interpretation air Metlical MalpracticePayment Information

As slated is 427(d) ofthe Health CoreQttolftrionpmteoitc,trAcaofjyg5, ISamended (title IV ofpcblic law 99-660).‘odin 60.7(d) ef the NPDIS mgnlatioucn,“[A) panmect in scnlemmt of amedicalmalpractice uctintn arcltito shalt net becnnstntcd an cccsticg a prelamplita antmedical malpractice has cccsteed.”

The Secretary ofHHS scdentaeds thansome medical malpractice claimsepaalicrlttly those rniened to as sttinarceclaims) may be seeded foe cotvenirttcr,netas a mrecnios on the peafessionalcompetence or peofessioeal conduct ofa

Regocting entities shauld pro”ide ademailrd rartatine no describe cite acts oromitsionsaadittjariesoritleestes 5100schick tltr medical malpracaice acOrn orclaim was based. This tarrutisce may bnumasinttms of 2c000 characters includingspaces ard pm ctttalian. Ass: chasaelrcsoyer2.Oan arc o,sncalesl.

Narrative dsacniptions shonld ioclcderight general ealegaricsofiafnemslian:age, sea, patient type, initial event(medieolcceditit of the patient).pcoeedare peefnemed, claimant’salIenation, associated leral and otherissues, and ocncnme. ‘lanai] rca caccateottta]n patient oaanes Oraanles ol’omlterhealth care practisioncos, plaintiffs,ss’itaesses, or ncr other individualsinto tvcd in the nase, Gaidelinen for hewcatecoeies follow:

actttetitnr ofthe ittisial crest age is eapressed inyears iftheclsicvmtsis t yearefageerrider, is tnnstlts Cram I mantit thmsgttII mouths; and in days ifthe claimantis less than tmnenilt nfage. a_tukztunmay betted ifoppliesbtr.

Sm— male. female, and dispnted;diapoted man ho used inclaioininvolving icdividuals whose nra haibees physically altered nr it-ho amphysical ly ono sex bat Ii ceeeltcntsllyas nun otlarf.

a Patient Type—generally an ictdieationofinpstimt or ratpaaennstattas;choose inpatient. outpatient cc both.

laillal Event (Medical Condition orttmePatieut) — choose the svords thatbest describe the diagoeais with as-hicbthe claimattcpreseated forsreanment.To report the diagnosis, the rapormissheadd star the nct,oal condition fmmwhich the pail cot suli’eeed. ~tt’hen thepatimt has mane titan otte canditinscthe reporter thontd ass the concdilinnthat is mons applicable so thegmteeatioa ofthe claim.

Procedure l°erfuriaed — dtr treatmentrendered by the insured In Oar patieofor the medical condition drscribedandre “Medical Conditiotcc’fthePotent” lfnaare than one pmccdurawas used, the prrcednre that is mostsigaincsei so site claim’s generalistshould be used,

Clatmautea Allegation — theocnunmnce than precipitated thr ctainofmedicalaad’or lecat datoanca-. thetimesequecceisrolatisn ha the initialevent is relevant

Associaleti t,cgut and Pelter lmnm -,

say associated issues that hase sitimpacn on the claim,

• Outcene— a description of theotncotoeresocltitce fcea the initialecent and the claimant’s allegation.

Sample Descriptions for rllnnlr,uilvcPurpnsm Ontyr

.4 65’ycar’old caIn oucputient hnd ap~s~ne~~am by Or, A. Sire mrnths Ister,the patient scan diaenoted byDf, B tshlt

fhaot,a c crote,

prcslatr cancer and undensestsargrn’.One 3-ear later, the patient sated Or. A foralleged failure to d’agntosg, A setlirmrntwas reached in ttts amount ofS7SO 000

A 57-year-old frmalr outpatient hadmaa000gram, Cnn year later, the pttieetsass diegnased with bcetst career and sitetundenseot chemotherapy and radiative.The patient nnm the physician for allegedfailure to disgoose sod treat.tess macbed in the amonnt ofSlOo,llO0,

A 45’year’old male came Ic thecntergencv dnpsalanmc with complaints ofsltoolderand chest pain and he scandiscltarged nAcr es a tnatiao, Six boneslalef, lie hud acardiae arrest and could natbe resuscitated, lice estate sacd thetreating emergency room physician furalleged fsilcfc to diagnose amId lanae Theemenvctce is trial and cesthed a’aaverdictin fuvoroithe plsiotififer 51.000,000.

A 9-ntooth-old girl was smn ins privaseoft’tee svitlt lever and treatedsytntptnntalieally, The east day’shesvnsbraeghtnotlcettospi al incenvolsions,14cc parents allege tItan a delay in thediagncsisofmenioginis csased prnnmeotnecrological d~~’c-Acetilemrnin~cached in the amoant ofS2,010,000.

A 3l’yeac-old pregnant ‘vaman stan

admitted talbe Itospital by herphysicianis the garly oaees nflsbor, e~fler fourhncm, the wootan begat to ihnsc signs offetal distress, The hospital stati attemptedloconmecthe physician but roald rotIseste her for four hones. ‘The paticuu ratedthe phy-nician, uilegingnlmat the physict’m’nabaadonmesccausenl penananennneurotagical dumngn no the child. Asettlement scan macIt cmi in the atnaust of52.000,000,

(Ponsiras adapted ferns he Hncnard Riskhtantacemest Foandatian Sample ClaintOrscriptiotss.)

Repornine aFPaymeots by Individuals

lirdividual snhjeets are nan mquired toreport paytneals they make for titeic ottobenefit to the NPDB On August27,1993, the Cirraia CounofAppeals farebeDisarms ofCol umbia held that [di) (DCCir, 3 F.)D 1993)1 the NPI3B regclaticnreqairinc each “person areotits’ thatmakes a medical malprucaice pay’s eon svssittvstid, itmnt’aeas iancqaimd individualsno report soch psymrnna. The NPORremoved reports pteviouoly filed anmedical malpractice payments made byindivi’dmts far their nan benefit.

A professional colporation or adlerbusiness entity cnmprited afa soleprnelilianer titan makes a paymoecic for licebescftt of attained practitioner mustthat payment it theNPOB. Royoevrr, ifapraccitionerorcdter peoson, rallier than apmfeosinsal corpomcioo or other businessentity-, makes a medical mslptacticapaymesa cat ofpcrurosl fccndn, hopayment in not reportable,

Payments inc Corpnrantnns nnd)nospilats

Medical malpractice payments nta dosnlcly for hr benefit ofa cctpcmlion suchasa clinic, group practice, or Itoupinal acecurrently cot reporlable to the NPDB, Apaysnemtl made icr the henofte ofapmfesaisoal cotponalisn orolltcr businessentity that is coeprited ofa notepracoitiaoert’s reportable lithe payaoennwon made by 0cc entity’ tuthrr than Sn ricesole poactitioneroucofpersonal funds.

REPORTING MEDICAL MALPRACTICE PAYMENTS

ted Scssr,sbn, 2aOt soraasleracmt c’s

‘POIfstdatcnh stunts C aopc,t

Omeused Pracoin lances mmmd in threcmploisl, hal act inrelease cr final adjndicacien, is reqoirrd m

One of the principal objertives ofthe long at hr or she in sslrtciently describedIn.PDB is to restrict theabihily of asno be individsally identi robIn.incompetent physicians to move fromStair so Stain withnscdi,closcan ar tnsnnace Policies hat Cnver Morediseos’ervoftheif prevtoat damaging Or Ihun One Praetincostpeteot perfnnmanee, Site 1410013requires onpototee medical ccslpractice A cnedicsl osalprsctice payment mad,paymrnts mad, frr the benefit nfdecmned tInder at insneaoer policy that cetera macropractmtianera lot ‘car their benefit throtgh nlann ccc practitioner should only beheir estates) becaayr a fmmcdulcnt rrparlcd for the individual subject for

practiti ener coat dassucce tltc identity ofa ‘those Ineseiml the payment ‘sat made, nItdeenasrdpcactiltomtgr, far even’ prnetilioncr named on the policy.

\Vlmemtsn bodnioe an MMPR fora One Settlenime mr Mate lhto Onedeceased pmchitincer, check the deceased Praetilinnneblock ccx the apprnpriatc MMPR screen inthe IQRS, The NIcOB mnakes an electronic Itt the cane ofa psvmentmade forshereport vcnftram’ eta avnitsblo to the benefit nf maltiplo praclilioners, wherein itreporting en thy vic the IQRS. is impossible to deignsinr the amoom pald

farthr benefmlofeaeh iodividtialtdctettryinc Pearli000ners pr,mclitiaarr, the insurer osuan tepuct far

each pracoil ioner, I me ralal (tmodivided)Is order for a txaraicularphyniaian.drnlist smoaai nfdur initial paymencsud thrnatalorolhm health core pmctitioacrto be nomber ulpeactitioocrsomtwhsse behalfaasoed in m MyIPR sshmitaed On the the paymencssmtnade. In the case tfaNPDB, time pmclihinaer mimsi be ncnmol is paymenl made for the benefit of mttaltiplcboth Oar ncritl,.’a complaintar cia ion pmctia’omtcns where in ‘is possible todemanding mnnglomy’ paymeat for apportion paymesn macnets to ‘mdividualdamageo uud the nenlemcet release or practitioners, Ihe innrrcr anna report- farfmral adjndccalion, ifamcy. Practitioners melt praciieianer, t hr netcal amonmo paidnamed in tho release, hoc ant in lice wrinen far lion benefit of that peactitinuer.demrmcd or as defendants ia mice lawsuit,are not repanabla to the NPOB. A Rest dents and leilecanpractiticnernaooed be the ssrillsncomplaint or claim who is stmbucqner dy Reports most be rabmilted no line NPDAdismissed from the lasvsn’mt and nat named stltea medical malpractice paytoentsarein tire ncclgm cat release m‘5 notreporlahle ccadr for alto benefit of licensed retideatsto the 14110B, In soar Slates, the p‘ten eriniems. Medical ntalpraeitco paymentsname ol’nhe practitione, does ten have no made for tate benefit ofhonceslafl’insnredappear ‘is the retrase or final ndjudicat’mon b5’ tltetretnpl reels ace atsa reportable toas Inng as the prachiitiaaer is sttTmeinntly Oar NPDB,described ia the setntenteol or fmaludjudicoti Oaa aten be identifmable. Ia thoseStairs, an NPDB report on dmr practitioner

a000anl’oJOsl Etac-to srrsnnbrtuem

span C,~&aacbcrlr,ntaasarm

Sun dents

Pay ,aentsonadr fee the benefutoftntediculor dental students are net repoflabln to ‘heNPDO. C-nlicennedsladnt,i providersprovide health care senlees exclusivelyandcrnltepenisien oflirensed leenItitcare professinsalsioataainiagensi totnernn. Students do tot fall into the‘otiter health eaepmntidnnercatege,y;’ether health coot practitioners age licensedby a Store os,d’orcneet Slate regiotassli000rcoriiftca’inneeqai

Practitioner Fee Rerunds

Ira refnnd oft practitioner’s fee is madeby on entity (incladitng ooto inscerporancdpracnitinttcns), that payment is reportableto line NPDB A refand made by onindividual isneeeeparlahl moOse NPDB.

Forparposes ofNt°DEt repertinne. medicalmalpnaetiec pavnneens are limited noeschnogn ofnaoney. Attfaade fa Ten iseeponable nnly ifit renolna frets a writtencamptaittlere talon demanding taonclaeypay’nient foe damages. The nerittencomplaint or elaine sense be based toophysician’s, dentist’s, or other health carepeaclttinner’n provision nf. or failure noprovide, health care serniees.Awnitten,cnmptainn or ebian may innetade, ban is nonlimited Ia. the filing ot’ acanse ofacnionbased en the lass- ofeorn itt any State erFederal cnuat or other ndjndiealive body.roth anactaims arhifruniont board.

A retiree ofa debt in naeeonsidnred apaysntene and nhentd eat be repented In theNPOB. For roanaple. ifn patient has anadverse reacnina to an injection and issvitlittg to accept nottiver of fetalsetllemenat, thatncalvce isn at reportable tothe NPDB.

Loss ,Adjnstnnent En tenses

Lass adjtasttnenn expenses (LAna) refer nocxpcases other than tttose in compensationofinjttries. snch as attornny’s fees, bubbleRota,. copsinp, export wiatess fees, aiddeposition and nranvcnipc costa. fLAtsarrant inninded in the medicalmat pnactice paYment nmoann, thny ate notrnqntined to be repored to d’r NPDB.

LAgs should be nepotned to nine NPDIOo*’if they arc ‘mctcdnd in a medicalmalpractice pa>nnrrnt, Reportingrno4ni,emer Is snnecifv than the natal mnnouniofa medical tttatpructice pamaent anddescription and amoarent oftbejudgnnenn onsettlement and nay conditions- ‘atctudingternas of paytttnnr should be cepntned to theNPDB. LAEs should he itcmizest in thedescription section of the report kent-

Din ntissatu In Defcnttnitt Penn’sit

A payneeni ntade to settle a medicalatttptntctare claim or action is ‘notreportable to the NPOB iftttr defendantIneattlaearrpracnitinneeis dismissed fromthe lasxst,it prior lathe netttemean orjudgment. Hansevee, ifthe disntiasstresults from a condition in thetetllrment or release, then the paynnrrnn isnepotnabte. lathe first insttnee, them is nopaymect for the benefit of the tenths carepractitioner because the ‘mdisidant hasbeen dismissed from the acdoointlnpoadrntlv of the srlntementn orrelease. Inline starr insta,rcn, ifthepeaclitinneris disannisscd frotu the tatasaitneont’tderation ofthe pnytncnt baice

made it settlement ofthe losconit, thepayment can only be coasha’ecd Ospayment far the benefoc of the health care

pmccitiencn and mast be reported to theis’PDln.

Enamptr: A henlutt care pmctidenerisnamed iota lao,nnil. ‘The pmrtitioneravers tan pa~mentoo the rendition thathis or her tame does ret appear in thesr,tlesnent, The payment would hrreportahtcto nine NPDB.

Hintt’t_ow Anreemrntu

A ‘ttirh.tnsn” agreement, a canlmctnalbrrsreeaaptsintiftasnd a

defendant’s master, defines line pait,ncteriofa payontat the plaiatiifmoy testieralien n slot or nabilnatiaspreceoiise. Ifthe finder of Fact rctums a defrnoe rerdict,the defendant’s iasnrerarmns In pay die‘‘less rod” amea,nt to nlte plaintiff- tftherender of fact yemen naveedici Far theplaintiff and ageiant the defendant tinedefendant’s iasnree agenes to pay the °‘ltiglncod’ etnsntntnantte plaintiff.

A paymnnt made at the towerol olahieltnians- agreement that lain ptaer prinrtnanrerdiet or an anbitantion dmismnn‘staid ant be reportable lathe is’PDB Italyifthe fact’ftnder rtttes in favor nfthedefnndann and ansiens no liability lathedefendant practitioner. In tttis ease, thnpa~~enlist,an being trade fnr time benefitofthe practitioner in settletnent afontedieal atatpearcice claire. Router, illsbsnittgtttade pummuanc a oat independentrotateact between the defendant’s insurerand the plaintiff, Jire benefit latheinsnmr is liar limitani atn en its liability,en en ifthe ptainniffwins at iniat ml isasssrded I ttiganeronteaor. list henni’tt tathe plaintiffin a guaranteed paymentes’enifthem in no finding oftiobitiayngaioon therractia’aner.,h’nrr:hu on’ulerfai’ rare Ira’easelpauaan’,e en be rrcnwttedfrnm ale‘ejsnrringrrqnire,eeaas, rhefcoerfimdcr

mono Ruse nssck a elcaea’mi,antoontrcgeraftntg ftatbi/ner re lee trial orce’bieraeio,tpnnrcread/ng.

A pa~svtnnlmadearthelnigttendnfnhegte mada Err the benefit of

ttte pmctitiooeraod, therefore, mast bereported Or the NPDI]. Whoa aderendaaepeanuittnttarttasberafuundto be liable bra eaei.t’undine aatltueien’,

uch as a dodge, a in tn or byarbitration, any payment made

nina that fading stunt bereported, regardless of Itse rxisletter urahigh-ama uerecmraL

Ira high-tow agreemennn is itt place. atidtIme ptaisaiffard defendant settle the caseprior tonriat. theenisnence afIRe hiah.tamngveenncntm teenage alter the rrpcrtabilitvtithe setiteteent payment

Esmatuttttol’. A hick-law acesntnettt is inptaeepriarlrtniat. Theparutsngren Iantow end payment cfS2S,000 tttd a ttiglmend payment ofs 100,000. The joty~ fendsthe defends physician liable ted ussards$20,000 to the ptnintifl’in damages- This$20,000 pavntent is reportable because thejaary fraud tt,e defendant physician liable.

Esstnpte 2n Alnigtt-lasssagrenmeotisinplace prior to bindinga~~t~tins- Thepsrties agree tnata,vend payment ofS50,000 nadatagh cad ptymea tnt$150,101. The nebitaator finds is favarefthe dnfetndantpnnclitiener. Hnwen’er, dometo time exisnettce ofnhe higlt-bussagreement, the defendant’s insurer makesa payment ofSSO,000 to the ptaiatiif(thelen end paynnenti. This payment is notmpntiablesiceeitis being mede pneouannloan independent contract hetsecen thedefeuetann’sius onrrand the pbubstill.

nit iapmtrt2tstt

~p’ec nerves otto Ostceinch

eramplr 3: A high’bawagreenngaaitt’e 0810 nfahe orgaab ian nttnnnnada theplace prior to trial, The paraies agree in a paymenttosn’ead pa’nntanr of 550,000 and a higttend payment ofSIsO.ono, Reface die fact Fee ittfarosatiao on reginterinn anfitdee restmu a verdict, the patnien scale arstbaeiaed uc‘eta ordcs’tgnatiogonn, seethe ease br $50,000. 1~spa~’rats’s pages B’? and 3,1, erspectivety,reportable bmausei I is made ‘tn,etilemeottithe ctoim i5ay’tnteut. by Multiple Payers

Example 4’ A hieh’lun’e aeregmetn isis Any medic at mutpnaenicr psYer that makesplane paine to trial. The panien arree no a an indcm ‘its; payment far the benefit ofabuno’ead pa~ntent ot’550,000 and a big’ pencIl’ macc mast sabmin arepom to theend paytnrntofstno.000, Rathcrthan go SPOil. Generally. prima, inaurersandto trial, th, parties agree to binding e’cnessisvtare,s are obligated m atake anaebiranijon to niseas the omanma of indemnity payaneot for Ito bemfit afadamaret the ptaint”tfwiIt receive- The pracniaiamee and no mote submit a report toarbittatecassanis the ptaintiff$al,001, In attn NPDB. Tspieally, reinsuren aretim’ a case, dme aehimatios tunis ennthtated to ebtigaled to make an iademtnitypayoesndetcnaina the amonnn ofrecovcayb’ tIne directly to the pritnaty ‘tasmmrer0 rot far thepttietiff, rot wl,etherrrnon the plaintiil benefit ofnhe practitioner, and secantwilt eeeesrr. Because no liability tunis to required to nahmit 5 report to tl,e SPOts,be deteua,iegd at this arbitnlionpmceedsng, the payne ccc is mode in Far enample, ifthme prima,5- iasarmnsettlement ofihe claim and is mpatnabln. contribute taapaymeen, all three issnann

ace cc qoired ta ntbtnit ucpamtc MMPRs InReporting by Anultorized Ageots ring NPDB. Eaeltinsarerslaa,atd describe

the basis forttteir peymert in the aoarntivrlien aruauizat’nant that makes the antedicol description of the setdemrat no avoid liemalpractice payment is the areaa’acaintt impression ofdeplicalt reporting.dent moot report medical malpracticepayments to the NPOB, Structured Settlentetutu

A teedacat malpractice payernaaychcose A tnedienl malpractice payee cnten’og intoto sac art adj‘asting company, claitun a atenaciared snlnlctnest ogcentnennwithasen’ieiat cmnpany’, or last finn, nctiung as life insaraneg or anntaiay company meaths antheoieed agent to cotoptote and oubmir a payment report within 30 daysaabmit SPOB reports. .Aa ‘msntaace a ftrrthe lump saInt paymeat in made byconnpmy may alto snoish to have nit uf its the payee to that cumpasy.N POD carrespaadmce re latcd to reportshmdled byanatttttor’tzed agent. Thin in Payments ma drafter dte opening ofthrstrictly a macer ofadmiaishative policy SPUR (September I. 1990) orderby the mrdicoi malpractice payer. hflteut annuities mislian peinreo theNPOBrepotliagn paeoteatt, the reporting entity opesingarunotre portable to thrNPDD.information in tb,e bINPR nose becompleted sting ttte name, addcesa. and

cia tnnnloeomaaut

nartrssetrwt nix

,_pascvthhsek steam C napes,

Suhrugaliou’Type Payments otrnhereiesneer with an aeenc’m theUnited Stoles in subject In service twhinh

Suthrnpolien’type paameats made by one means th oa moat be sen-ed” ith a Fedetali snarer cu an a atmerare not required to b. camptuittt); thceefute, the rrpartiocreported. provided thst the iasurer requirement can be eatneceul. Icreceiving rhepaymeot hasprcrionsty NPDB’sresponsibitity tu identi& thesereported the total judetnrrt or settlement ~mpoties’, rather, ills nine mupousihitityno uheNPDo. Stthnogatiosoftta occats or theseeom paaieato comply with the“hon nhrreis a dinptaie between ‘mannance mature and register ntith the NPDH,eoatpteics oserwhese peafensionalliability policy ougtnt in respond ton Payments Made Prior to Settlement

t,t,’hrn u payment is made priornosF.xamplm A pr.aco’tiattoc is iooared in setniemeat orjadnnmeat. a report mast be1991 by Inusree S ned changes ever to eabtnittcd withim 30 days fmsn the date theInnttrerY iu 1991. Batit palicirs provide paytaecewas made. Since the tentmcstaeace.type coverane..A medical amenut niche payment is uoaknennnt, thetaelpra~-ticg I anconit is filed in 992. Th em medical tnalpranttcepaynr dtnstd statelea dispute over whether the alleged atnis in the aarea nice dcsceipti Ott sec lion ofmedical matptmcnice arcuncd itt tate 1991 the report. telnet the setttentent ororencly 992. Under the 1992 policy, jcdgnnent is finalized, the itncrartntnccr 5’ neaccs Ia drfem,d the lasysait ban nabnnit a Cocrreuisa In the loIol Report.obtains as ngnemarnt fcona the peacniaierenth at it nay putnate the peactitmetor’s legal When reporting medical n’alpmc niceeirhttorecorvraunminademniny and defense passnent infomstaliont, please heosnee thatpaytnctttn that slionmbd have been paid tcasin0 the Pay-need Renutireasota andutder Imarer X’s polmcy. Thisis a Dare nfaudpa ctrr Settlemeatfoelds Carabroeation oememem Thejiny the MMPR famnat blank’tadicates that thesnthseqmmently deucentnines that the ircidcat payment ‘sn made priur to ajtmdgnnmt oroccuned itt tot and aas,srds SSot.Ooa no settlement Wlneaapa’crnent is made as athe plaintiff. Innuter V ttalnen nite tctnttofajsdg’acotorssrltrmecL these$900,000 povtnent to tire pbiaaifl’md fields should he property nemplcted.eeportsitnathetsPofl. tnsurerV seeks Lihrssisr,tmre AdjadicativeBody Casessbmgatian ,afils iodctnnt’tv and dna’ease Ntmlrertcidjadi’cntis e Gedy Name, andtaytamtufrcmlnswenX. boater S CnunpiteNmmtttbrrfietdsthoubdbetrft

ultimarety ronceajen mmd pays I usurer V blank cttly when I hete “as eat n filingthe $500,000 plus defense coats, I tanree with ann adjedicativg body. See Table g•zXt’snetreqnitedtooeporiits espageE.t6ferinfarmnamanotecimbaneotena nFtnssrer V to the SPOB. dttertniumtte rnpnrnab to rnrdinal

ntalpnctmcr pavtnents.Offshnra Payers

A medical matprannice payment made hyatt oifshote medical nalpoac lice insurermesa be reported to rIme SF03. An

fioroshmattIt c—Is

0-ron roioocac

0-16 snrsosaossoi

onset, ERcsvni 0,706 Oaijntaus

Adrerseactinnslnrolvinpvcnsunea. mon hestrbminned “ben the probatimuatyrepri nuasdes or admanishmeets should nsl period ends.)be reported to the NPOII. Mutters no’relaned lathe professional criepelenue or Inn adverse action noah to the clinicalprofessional conduen oln pracci uniter privileges ofa peactiuioeer is based onshould nun bereporned elite t’IPOB, For multiple grounds, only a ninole reportesomple. ads-eon actions bused primarily east be submitted in the NpOB,onapraclultuner’s advenoising piactiecs, H6~~vor- all reasons for the acnint shouldfee smuolsee, asian anratinesarnl, bn reported and explained in ‘he oatnulls-c.alit liaiiosssith olltcraasoc’ualions or hestth The reporsngenlil) maytetect op Is fourrice professionals, or othnr competitive Basis for Actioa codes a itudirate thoseacts intended Ia seliricor retain basiness ntnlaiple reasons, Additional reasonsate excluded Irons TWOS reporting uluanid he sunumariecd in Iho narnatis-nrcqa’utninentu, dn,rription.

Sec Table 6-3 an poge E-2l for more Denial niApplienlinensinfoenrallan on delemalisiug reportableacniasl fcrctinira] pus-i Iegrs. A restriction or dcnutal etc liiiical

privilneos thu torcaro solely because aHnslnilsln and oilier health care enlinian practitioner does noi recta heatiln caseninsi erparl run-is ions no pros nasty ~thresholdrepnrled adsresr actions, For~ore eligibilincriiaeis fur throparlicnlurlornrmallan nn rrvtsionn, see page 0—5, privilege snot reportable to the Hyena.Revision In Action, in the fl-pt. nfRcpnraxneetinn, Sacluroslrirti0000r deoiasanenat deemed

tire rcsall ofa praleasioral los-ie’s- ac~ anMnllipleAdserse Admits relating to the practitioner’s profensionul

cnmpeneocnnr profesni anal con davy halI foci ngtc profesnional reviewacdos are considered decinions based onproduces mollipte clinical privileges eligibility.actinsa (fur example, a 12—ntrsthsanpensiun Ibliossod by a 5-month Foresarspie, iaxinnliaatiaixeearoaotuvei5-prohanion), outysue report should be changes the eligibility crileria for asnhueinied to the NPDB The Adverse paeOiculnr clinirnl privitere, a pinynivianAdios Classificolian Code far die nisal does nor meal lbe new crilr~an~-illprinripalacliranliauld he sabmised an lose pres-iomhi graotedclinieal privileges;die AAR, rod the eusensilive denuripnits thin loss ol’privi tegts is aai reportable Ossheald describe the addiiiaaat ndseese the NPOH,sshntn its posed,

,~alvetue clinical paisileces actionsA Revision to Action must hessbinitieoi nepovtabte to the NPIJB rassair froms’ hen each ofthn analtiple acniem in lifted, professional revieiv arnirns relaihuig Ia theQ°ollowiog the previous example, a praciiiionvr’a profensioi’at competence or

ren’is’uen maul be sabmiaed wlienctinica I pral’rssional condncn,pvisitrges are reinslaned with probanioantser t he nsapeasion, and anon her revision

c-il suriaobrudnsi

Reporting Adverse ClinicalPrivileges ,kclionn

cave entities niast report adverseactions ssithiis IS da’,s Iron’ the daieiheadrerse acninn ness taken or clinicalpsisileressseeesatsnnarilo sarrendernslTim henllh earrr arty mano print a enpyoreacls report nainnuilled to the NPOBand mail in In lime appropriate Stalelicensing based for ins use, The ReportVeesfieaeian Dacarniesas thai health careentities receive after a report insaccesnihilly proecssed by the NPDBnhoatd beaned for submisnios to theappropriate Slate licrssise board.

Reportable adverse clinical privilegesactions are based cut a plns-uician’s ordenltni’s prnl’nnninaal enmpenrnec orIirofess’itnal cnndner than •dversctya15’aois,or conld adsersety nieces, sheheatnh ors-seirare ora panirtue hospitalsand alliereligibte healitu rare entities nnnstreport

• Peolessinsalrnsieso artinnstharadvenely affect a phynician’s ordentisfoclin’ical privileges for a periodof mere thus 30 darn,

a Acceptance ofa pbysicinn’s ordrndsn’s siarrendnr or unslriction ofclinical privileges stile underinvestigatiaa Ian possible professionalinramputenice or imprepar professionalcoodoct nr in rciuum foe nat conductineas iuvestigatiosnrrc1ssasahtnpml’nnsirsnl review actios.

Adverse actiensiahen acainsiphysician’s or d entinn’n elisical pn’vi legesinclade rednrinn. restairtoc. saspesding.invoking. on desyiso ptiniileges, and also‘siclade a trealib care enemy’s decision canto reness’ aphvsiciaou’s an dentist’s

legenifdiat decision nsa based on thepraccilionsr’n pvafessioaal competence orprofessiosal condavn, Health careeunninlnn mny rep urn such aeuinnn nakeuagslnsn nheclialml privileges of oilierhealth unix taranuitionern.

Oosonssb,naoQi s—i’

Nposcvanlss* Thasnc F unman

Winhdran’al ofApplientions Cuideutacs for nnsmniganiann

Vetatiaty wiihdran’sl ofata initial • An irreuligation maci be carded nunnppticatian forntediu at svillappainnnena by abe braith ca ye eenity, urn morcilnical privileges prier In a Sinai indivi dual re the italY,

~~p5~f~5ni • The investigation orion he fucasedor

pencsinioner npplirs for nenessasi of medical r’~’ -staio’appoiiatment or clinical pciviteges and • tine ‘anvrsileadasmastconcernittievoluntarily srithdra sss lisa I applicant’on professional conpeleece aisdinr“bile under iteesnisanioa by the health prelesni anal cordyccol the prnvtii’issercare entity for possible professional in qnntniosincompetence or improper professional a A emutice or ceteral es’s iess ofcasas isconduct, or in netam ferirascoodaxiing m tansnich as iosesni ation cc talumno a r -

prolessi nnnt rcsi esv action, nhra tht nvhysaline reviesv afapanticularssiihdmsval nfapplicatlnss loretinical pnsvti henertsnotan issest’igalionprisilagcs ‘o reportable 10 the NPDB. •Aainsesniggatiaa shoald be lire

- - pn’rcutsortnaprnfessional resins,Invcsnigaiunnn settur

lcvtull ganians shoald cisc be reported ns a As tnscs e,ilion is considered ongotsgthe NPDBr nob the narrsnderor inn I nbc health care oitinns’s decisionraleicninn ofcliainot privileges while niaking osthoriep mites n p ant oxides orunder investigatinn or in avoid fnmtatlvrtos en the invesnigatiowinsexcigation to reportable. This ssontd -

itnctsde a failure corenewrliaical SnnamanSnspetsinnpeivi tvgen 55 kite asder inseutigatian -

A samnian saspee sins is reportable if in mtA heal thoare cit tiny that submits an AAR a in elfern or imposed far mom than 30based on strecnder nr enalnsctton alaphysician’s nr denuiss’n privileges sshile -

ander invnstignnian should base • Based on the professions I cesi petetuvecerscmposmeouo evidence ofan urgoing or pmfessinnsl cnedacl alIt’sinvestigation at the title of nanender. ~ physician, denlist, or other health careevidence nfn plea bargain, iiic repovilno poetiitnnee than adeeroely nifecis, oecathy shastd be able en pm dnce evidence cnatd adversely affect, the Ineatdi orthat sn’unvescigati on wan ituliated prinr 10 ssellare ofa potentthe surrender ofelinical privileges by a n Therescia sri professional reviewprncnaiener, Examples ofacvcpnabtr anion laloec by a hospital or onherevidence may mnctade nn notes or tuceisits health care eetilvc.Penn rommitnee meenings, ordv’rs 1mm -

hospital officials diaecidngan A sautetiun-nuspetision is often impnsedisvestocaninn, nnd nonicea no practitioners by an isdividual, forinstaa,ve, sheof as ittvesrigation, rhaieman nfa deparunert Cnmmonl>;

snptsubnlcOi 0-in

Table E-2. Ouuerntiulng Rnpnrnhln Medical Malpractice

,sdlm Npnas,pneonn Rmtaaca]hdiivA nrcrnneico oatttnomt re nennnjndnmo,I class I-in tarotinaiadea uiigdntien that ha ‘nm ace hipnmttdnutidMalpranieenentnseniisiouruaendsothn itrg rhninidatpa5annstnfterts7rnupooiao;sluiosna,nmoniu-anasaosodnamhramh1-ea,ha rdenil0-asmxhipiepmsnmnaavshoixiotposaiuo nmte,nmo iosnlses ave pinutitianan. Mms lile mmcm report as ‘sob ofthn use

Pasos.siiainudrhaasdontvmo,atdere,aseda tcumneiuisoosiaodPartners, made by nsindindaal Arsisrnssi050tonapenntis0006thobasin,saeot,ts

remained cruet. pnnti tiuten mmi men areatoo ‘quest lannqsiied tunas ixasidsc maniamsonu000rmmannlthadv

Posmento nod. rae nmpe,aais’m and hespirnts Oar tnmlomnd, rsotba heaVe nfa rnepootlss,aah an .ulinio anna, psaanbe ml hospital ci, mlasnoendr inumsolute. Pa~os.on is mpmnthtn notsaniudefor hmiuuvv ‘ohms eaop,uied octal.

Pasmeotssuuua toelinennod,nuidmamdisin,nn Msefit,repawF,aavm.e rca netioud, thai nm i,ps,s ifmtondit nude bs- to eniuy

ll,atsdiog not, inempexead r,00itioamnt. Thenrnnnnt is neqvi’si sta,cund in made h7 .aindicisuni

Oissuusat ordofmdoet lenin await, rio unswn eon,ired ifd.cmdan is disistusnd o,ioama naiitemeatsirjsdasnen,, Rapant is reqis,ed ifdisoisnainosdiarosooethdnnirsar,lnonesine

REPORTING ADVERSE CLINICAL PRIVILEGES ACTIONS

~Ic~

NrDtO ss!daock cnccpeac nips,,

action is then reviewed and canflemedby a liospisat committee, such as amedicalexecutive committee. an acihirized by diemedical siaffbytass-s. TSm suspensionwear/ti then be viewed as a professionnlreview action lakes Wthrcnuby.

lfthx suspension ii used/fred or revised aspart urn Itnal decision by dir gesensiogboard ornimilae buds, the health careeoti~ mast lien snhmitaRcsisiannoAction oftine Initial ropoot trade to theN I’D B,

antic physician, dentist, or other healthcare pnantiatoacr sitonenders his or herclinical poloitegea diaringa oiaormsrynaspcotiast, that action lasso be repanled tothe NJ°DI3. The action isrepomoablebecause the pcactilioneris aarrcndeciog heprieilrgroeilltor isltilr noderiot~titatic~ncoocenaint professional condoci orprofessional competence hat did arcoaldallen the health or tie fare am patient orir order a avoid n proftsniaosl nevicwaction concrrniog the snare.

Snnnnoary snspcnsinnn are considered Inbe final whoa liter become prsfeoanionatreview aclIston throng I’ nrulao ofoinennthoriord hns1attat cnmmilhrror body.according en the hospital bylaws.

Chnpoerropeoa -

Esnmptelt A lt.day suspension inimposed osaroonit urn professionalreview ad/er based oomophysioiao’nprofessional crtopceeorn.

floe ace/an tattoo reportable tremor lieado/on taken brIbe profeso/sn,nl

rn/ow iooafs did eon loon fsnromnre than 315dsops.

Ena.npte3m A hospital ros/eassasorgeao’n professional cotatpelener andosnigas a surgical procnoo for todays. Thesurgeon cansorl prrfaoan anagoay withoutbrino emnoed apprnvai by the oargicalplaster.

Snocnol,esargesnroo,roiproco/c’esasrg,ja,teaohouoopprot’althoinoosoohrracrgeoo,rOar resan’coign os[dlor/col iarisntegen toreposa’oohle.

Example 4t A 3l-sOnyoospension is) imponed oo a phvnioioo for failure to

cootptntetocsliral records.

Sock osaspnooion tear/sd be rc’prseoobio 00Use NPDO (1site fat/awe no completemedico! records a’rkooedes otie physic/mt ‘apeofonstmettcomprac’s,coorcoosdttcosaset/nsh’rrselys19toeos orcstoloigadtva’se!,’offeeropoo/eaoo’s Occult or soc/fare.

Ennntplodt A phyaiciao’n application forsnrgicsl pr/surges is denied because thephysict’aois oat hoard cctsified in theparr/outage iinical npocialtv orsabspecintty.

The ocr/os to not rcpareshte if leepls,ustrtonfatas to nseeenhe ‘mospioa/ ‘amodal credeoesaliog cr/ocr/a app//cal/n e/fmed/cal nooffor c/isslretprbs/IegeapplIcants. Eresampdes of /s/riotmoo/nc/tale: gfl nato/oman pmofeas/ono!I/nb/lisa eosorage, fit bosnod rea’ihwoaion,

The basis far this iomerpresanieos is than,ptrssansta PernA of thei/a’o/th CoreQ~so1to’los,ro’oremrnoArn(42 U.S.C.*tlllt)/cs(2),asarmnnt,scnpossigsiseakeonnpcercal”immioentdamererra thehealth ofans, indiridool.5

lime Act itsrtf treats summary snspcosiooadifferently thau odarr professional reviewidiom: the peocrdoral rights ofthnpinemimioaerare provided for fatansing thestspegoion. rallier thao pircrdirg it, Thinreporting p01kv for sntnmnnry sospeonioosis in keeping ss-ith the purpose ofthe Actwhich into protect the public from Ionthreot a fincompcleoo ponotilioners

ooiog to poacoice without diocloocrediscossa~otfpcrsioan dnmngioe or

incrmperesn pe,faaonance.

to ostabtishimrg shin pohiei’on tho ropostioleofasosaisor nasprosians, Ilila asssmrsdint haspitalu use samsomy saspcosionsfor the punpssr slated imPart A ofthe Arc:In protect patients from inomineat danger,ratbeo than for reusoos that nsnrnanl ronninepnofcssirnal renew octiass. br/st alsoeoaphaniers that this policy en osonoars’snspcooiooitsotntv forthc pntpase ofmrporniapta the NPDB. md does rot adorelathe criteoju for immaniro nsderPaniAoftho Act.

spas Oo*bosh

3) gesgnnphio pros/no/op to ohe hasp/taOand fr/faa/tire ‘0 hare sserforosed i/meashrtnssot aamnber afprgcrdtsreupre.ireihcdfsroparsieasiatrcl/ssico/

Esampta Or Thciiosjaitai CEO summarilysospmds nphyniniaos’s ponsi leges forfailure to respond trait rmergoecydrparbneri coil.

The ar//osn/ureporoob/e s/the soupe,sotmrcntatatoesfaar “tepee then Saab, mid thelmsp/lai bj,10os .noaoethsasuanosmyosspesms/on decisions hi, the aartheo/

down/a/ce ore egmltlercd/o berofeao/oasoltes/esooco/aans A CEO assogbe eosaoidrrrd orvns,asgee o,ssims/mmg shegoicaanangiodcseeepraflssoirnulres*acacois’tns. Ifoh/s Is the cooe msd I/sepigw:ian /saac haoeso siaooosa/irsaspendes/.the dtompltai medic’adsooffbyiascnsts?lilstsottyproosllefnronoppeo/ in a/sened/rot exerts/nw c000so/soce to/I/aba a/ensdoss of e/sso CEO’a dec/s toe,.

Example it A hospilal’s toafesuiatulreview body terminates a provider’hasedphysician cconraee far causes relating topoor patient care, which in torn resatln irsions ofprivitrgos with oo right no a hearingas provided in th eeoilirnci nod lhr inlrdiealsIn 11 bs laws.

The 0mb/out/on of the conoramo, in ton c/f innor arjwi-iab/e to i/se ,VPDB. Site/ernonoa/unnofrlre jsmnar/a/roster’sclansrobprnskgen beconcoe eafa/te Oertsihisooan ofthe cansnserfor tvosotts relaO/itg to/onsfr.ve/ottnlcanspeeeaoce orprofenn/oota/condoco is reportable if/ri,coosaidered aprofessional rex/etc oct/si, Ivy aCne hasp/rot.

Hospitals are adv/sed /s conan/I ia/ri, legalrotator! isrevieinadae Soa/e’scnnrlsnmoraotrens/ngeineprocenn.

Table E’a, tialenanining Rrpornablc Acrison for Ciiaimt Priviloges

nnstdromsnssmensirpsorssnim.s000po;esrs,oo,saerasaat/podonpcn/aim,e ‘i’mdeosie 5/onpealod rfooe solo n/dam,. she prune/sInner nan,, liv ooaasnd wpoa.lbasso osesionndisni tuor a adosinieond.aaoodrnmoeasorernfpmfsnnisssalrrotponsso, npmotnninsnuioeedooacprrssoo Nophmsinins srdeo/rm. hat isn pearson 5soa a,ot oats aorta-S bncoon ssndog an apnaidodbrisno,aslisi500r.An a nonnrafmsiiss habitat polio1., a pevoson in 000iaaed Ian pleania tenor doses Nonntreslra,asiejsada.ssoisilonnAphssioindnoisssoinnodspoeaciosnonsoeosaosrtis*,mp/seerarsrnooeaod Noioasosic p,almoimai aanrpannoo nofossiredsssja ahem coin iesmdnstito.A plooioino odeotiecveit,ea,i is nation mrn,seimdros st/n/al psisilopoc piofmioool You

Lsvnsromsoeaearnnai seal cmdacs is coala, issnn,isnfso..Sphynlain,m domino ssOscssaOare,sia,onnmon,dnnuii,icatp,iuilopn,in,nmssrso Vontam mode,sion m isreo/nnbioo afpncnaia,nt remsnieo. or poot’eoolsssai ssrdaom.A pls.niciaa ‘ussr dmcnnnappliaeaim fsomtmiisal ssnavaepuismnot is dos/id based on Yesnrarmniasaism:pomconreorntnasodcoodsso.5 physiainna, dremis it dooind mndisd nmalrorpoism,,, unalinitat p/sai~en 005nase Norho mmrslsh so, oiomi’htntaa trues srinoialina in son tmnt:m,eanr’u dimiplbio.Ai’hjsrimnseimt aim clioimlptisilooennmnnpredodriraimieiuaoimo,000sasso Noeotoidsnr000insnimmnrtmsoo,pnir,ssaas.lOOndo..A pisyaieiaao’n as doris’s e.qymi ford imt roir/uioon is levied or root/coed baird op.s Vat

,_nanasmois 01cr_isis oap00000 no_defend bstl,a_‘oat/id.

sepsomiot am

Eaompinn orRopnrnahle and ‘Son, physician’s request for espandnd clinicalReportable Actions pe/vitrgon far reasons relating to

professional crmpoleacr.Example It A physician member ef ahospami n,odical slsilfosisitos so per/bent [hr attire in repastahte hocamano the dorsalrecent clinical tent, and procrda tea, bat rfprisiiegro adserset’; aifects the ct/ndo’s not ltavenienappcopeianecfnicat pr/ri iegcr sfthr pha-sician for isiager thanpriviteges. The physicn’ it applies far an no days.espaostan ofctunicat prt/ih,grs. Thsphynician’s Oepaasesmnn Head and liar Whether pnonicoiur actions ate rcpotxtthtcMedical SmoffCcedcnoials Csssemoimnge rind is the NPDB is often host deternaimmed bythat, based on theirassosoment of the examining a hospital’s oredicai staffphysician’s drmssrsuatrd professional byias-s, rules, amid regntamiroa svimtt regardpcrfortnaece, the pttysicaa‘adorn mint hare to proc/slain dafanine john ‘astor poweredthe choical conspe ienac In porl’oom tire to take a pcofeoeirtsai resiess ace/sn. whamaddilionaltenls and p~~darts, and they coosninstes 0 profesni coal rev/mwaci/aerecoaormrod denial gfthe Icctcrsm for than adveesei ytlfccmn nhrclinicselexpammdedctinicah privileges. The eric/Sores sin pmet/t/oeec, and bos, thathospital’s gore ruing body rrs’i cwo rite acnioa nolan’s to paofevsieoalcoamcane, nfftsas the fmdioes and or peafessienoi conductrecrinmeedsijorr, asid denies the

srposnboeronl tat

55’os as/swat rinecic irma,

Example St A ph sn/nan santrnders Esompte tot A physician holdingmedical ataifpein/leeeo dat to penonal coormcoy privileges m‘ ahsoapitat appheircasattn, iximonaity; orretmrnnoenm, fee fail snanffpe/xiteees. list fall staff

pr/site ens are oranird. As acondit’non ofTheson’emnalerosasamseportanblc The ,lslTprivuiegcn, tine ph~ic/nai ls ccqoi rednc’eounafarstsnrs’,aderore /strderasss labear~aIlintheEreergenoylos/ens theph3siesos sorrcoadera s/sale Department foe one oseckomtd a nrnnth.oaytre as /ocesoa/nol/sao by a lmealo!o care One to persoaal reasons, the physic/au/scmoS) rc’lm/og to possible profess/anal unable to fatfall his Eattergeocyismconpenenco or /npaanjsairpesfr.vs/onat Deport men, crnnotimn,enr. The hospitala,omdita’O, or/mrre/m’mtfaraoa emsrr/aac/aosg aednhte physic/na eventually agree toaoetnoasaoossvonigas/tmm chne~c Ism’sciinical pniv/iegea resin full

start’ is docrtrsy.Essmptr Om A plmynic/ao as‘at asmderins-ennigntinn four vectra prior to the /)5’ cbooge in e/immicetpm/otlegea/o notonpirat/to orb/s ct/n/cat peirileces. The s-ejnorrohle. 77sg chai~p an she /ait5alctmn ‘aptmsnici am, failed to renew his clinical pr/sir/pen tsnno nhceeoai/o n/aprivileges. profryomoss/metsoraco/sn tmedon the

pigs/elan ‘a proafeas/aonal cnmmproetsct tarT/osne,eia/sronsta/en’do repar/ahir roodacp uk/e/m mr/errs oreoaa/d oslawrset.pnsereoskrn Idle tedCr item-I/potion 7/mit ‘Vera he l,a’eolah or set fare ofopaotena.nca/ot/srcpsranhle rccsoreiPesaofor&tierllacph.nnariasn titan, /mgtros crater/nrenoigeatioat m nine hiss” loafs/led Co retmmsch/ac/ia/moo ;trtto/epea. .lproca/mloatee’nsnanaren.’so shaaona/amaealiges/nu/.v br/opcoasshorred knot oregmaieeanmeaooferre~rca/i/i5~:

n-Is

‘era &.o’sosrn X?otCn’dotest.Chpehtrruon

keporling Adverse LicentotareActions

Slate medical ted dental ticensitog boardsmass report adverse actions againstphysicians and dotttistn to the NPOB‘iRis 30 days from tire date ntt adverse‘toastier aesion ‘vat no ken.

State neslical nod dantat hoards mustreport in the NItOB certain disctptinnrvactions related to promensiasal competenceon prnl’essiatr conduct taken against thelicenses ofphysicians or dentists. Sarhticensare actions inetudc revocation,nunpeasiott, eensnre. reprimand, probatintt.and sttrnntdnr. State rtedtrat and dettiahoards must also reran revisions toadreese liceasum actions, snob ssreinstatemcat cia license.

F.treriin’a mace niActint’

Anftdveon Action Repros msni bessbnnitted within 30 days afRo dane arcticfeotsal nppmtat aftite licensare action hrthe State medics! or dental board or insanthorizcd official. Sigtdftcaat delays nna~’

scene hens eon the foeonal apptosal oftlteactteoaedtlte drst’ttne nftlte onter forpsbtcantott hoscener Itt, mogertiatotorreponnag the adverse icuton ohuosedan the hood s fonual uppeasot ni’tt-e

Examples niRepnrtalile Actions

‘The l’otlowtneads..ne Itcensare actionssslten related to the prnlesstesatcompetence or prafesstnnat crndaet sinph ‘stems or dernsn, tntmn be spotted nothe NPI)0

• Dectatofsnappttcatton foe Itcenne

~othdgownl nfatt ‘tpptacataan forltcstnsterenessal (should he reported asasoltanony sorrenderl

LtcennLsre dtscipntnaey action tales byaState hoard aratnscroe of tIntoemseesappttcanss fortrears’ si hosed ttpon’s Itreosteedtsctplontn acites eetatrd no thepmcntscrers prefesatanti campenenceor poofenstonateondaco taken b’sonolltm State hoard

• Licessane diseiplissey action tttsesn bya State heard hated si’oo thepractitioner’s dntibemse failure isrepeats licmrtre diseiptirara actiontaken by anethee State hoard. “hen areport ot’sttch action is reqaossed on atieeotaare renetsstt application.

a Fines and oth ertnanetaay sanctionsaceostpootied by otter Itcenscre actiots,such as teroestian. oaspensian,censure, reprimand, probation, erssosnnder.

Esanuptm nfNna’Reporoahte Actions

The let los’tne ad rense ticettsarcoctictcxshould nan ho reported to the NPOO:

rites sstdnthcrmonetarv,acetiansannccomputntcd by othre licesstaeeactron. s,tah as revocation. sttvpenstetn,cenmae. reprimand. ptobntioc. orstrrmdrr.

Otonial ofma initial npplicat’ton foe

nftsettleetent agreemeet which itnposostntooitoflae ala pntctiti ater besateciitc period oftiate. taless suchn’tnn’tteringeottstitntesnresreiatiao 01’the practic’tenee’s ticenncontidered te’beorepriossd.

A ticensotee disciptinany att’mn sshiahis imposed svtttt a “stay’ predingcc’atpletion of apecifta prc~etamsnrnctiunt. However, if a “stay” ofad’tsciplinarv ectiot is in companit,d byprobatiott, the probation is repeatable,

• Vatustney retinqairhtneet oftphs’s’tciattsI’tccnse lee peesnttst00000tto cot related ta Itin otherptot’csstraatcootpcteacc orprofessinealeordsertrerettmplr,retirement),

• Licettsnreac titan takesaeaia,st tan’physicist, nendeatisi. health corepesetitionen.

E,2a Saroee,tarzettt

came, c nereat ‘p50 OsiOcInsok

REPORTING ADVERSE PROFESSIONAL SOCIETYMEMBERSHIP ACTIONS

, .

;e’

flReporttug Adverne Professional Reportable accionn morn ho banedosSociety Membership Aetioas reasons relating no pmfesninsal

competence or prnlensiooatcondttcr ‘stitchProfess total anoint’t~ mass report adverse ofl’ectncrconld ndvercely atfcer the healthactions ‘vi‘thin 15 days thorn the dstn the or welfare ofa patient Macen non relatedadrernetctiaas,as Istisen, A copy efeash to the prtfessiotoal competEnce orrepeat nest to the SPOB stsattd he printed profrsnionot condncl ott physisita orand noitrd to the appropeintr State dentins see mt to he repeated to the NPOB.to censieg hnnsd for its tsr.

For exotnpte, tdrerv‘e tetiotis onaioss aThe Report r’er~iroomn Durieeeono that practitioner based peinanuily on his se bceheatdn tate ert’tttes aeceire oilers report is advetnistag practices, t’cennstcttre, sntatysuccess~ttyp~rsred by the hiPPO aotangrmettt. affiliation with etheratsoatd be ased for ntthnxtssion to the associatiatasor health cane profensinntta,appropriate Stntctiressing board, nrrthercompctinive tons itotended to

solicit or retain bnsttesn tee excluded fromHemming Iteqairements hiPPO rnpotnisgreqttireatenns.

Prniessisnoisoct’eti es mann repeat As adseesractiua taken byaprofmsionalprefesoi osat me stats osti ass bated on society ugainost the tnrsnheenhip ofareasons rotated to professional cornpeteare physician or dentist mutt be reported noorprafensietnat condact that adversely the hiPPO “hen that action coaslitates aaffect the metohersttip ala physician or prafesnirnalrcvt’ew scties takes in liedentist. Peot’esniana] societies may repete esnese ofprotcusi onsl renew activityste hadverse metnhcohip ae~ass’s’hea tlunaeh a tenon) ~er rort~’ process,taken sga’msn heatth earn pruesitieeern provided that the action is based on theother ihta phystci nns rod drotosts. tnetnher’s pretension at competence or

tat troaatnhoa 3001

tetaaehmlslo mis

50050 roidnoonti COsnote, r o,’eaw

pnofrssiona] conduct Adverse (5 U.S.C. 523s(b)5315, CMS trtaioo fullonembenhip scsi oat tns’ots’isp eeasrten, rerqnonsibititvfoethecontoosaedrepritnandn, or adsnonistennrenn sitcald non ofC7nIS enclusiptt reports; nile NPDB oslybe reported, eons nan disetasore service. tCotiftcatian

ofeuct osiatt Item CMS poogeatos in madeReporting Medictre/Medicaid by CMS. tnqtinesentlteappropnntennnvExeluaionn orcanlensofCMS axctnsiosreporns mann

hr eet’esred to CMS for respoese.

~ Zz:~0~t~oMIeshrodhealth cane peasritionerst were added to arocestismt’,~ o. oaF ‘sir!attts dentiststhe hiPPO dtroscas a csllsctiso effort satin 1eltfrn roasts ‘ ‘rio’s Pt, isis rrr S

Menontandt,m of Utodersiaading hetisera n’s’rn~iarn ag,afnse thoIfridos.ata ardor tintsHRSA, the ttftS Office nftaspcctoy oke’vsedhs’ofth ratIo jareaeeulionorsotrlCenetat (0t51), and the Cetitees fee estiaks, in u&rioioa to rueltasiOtto agtot’nst?siedtcsoe & Medtcatd Senates (CMS). healab mreaooirinm’rs can bofoaoesdittThe NPDB now inelades Medicate! abe Mee!throre feeegrirg’ areifloterd!saMedtettd csctnsonns frnm Mny 970 to Dai,o Book (HIPOBlthe peesettt.

NPPO Mcdirare,’tctedisasdetctasioos Sanciloni for Failing to Report toidentify prncnitiune 5 who hose bent the NPDBdeclared ineligible for stied’trace andMedicaid payments. hospitals, mattaged Medical hlntprosctee Payerscare oeeantzatlnao, and other providers oreptohihined freon billiog ths Medirarraed The 4005 Office oftnspccsor Genreat hatMedicaid programs br anyservt’ces thou the aatheeitytoi mpesects”tt mosey‘night he rendered by thrne prncidon. pe nahies itt arcoodance with Sectionstnfonnat’ton from the hlrdicare!Mediraid 42t0n) and 427~) artiste IV ofPohtice’cetaniatts is reteased ‘a accordance with Law 90’ihs, he Flretfth Core Qaaliaraloe Soriald’ccarier.sro, .toyrot’oaneae Art sf1086. as amended,

Aider the nnatate, any nratptacnire payermc tiHS Office oftnspectorooseeol han thnt rails to repeat medical maiprurtisethe oothority no eselo,de indis idnain and paymecnsia accordance withorgsniuasioss from pnrticiputiag in the Sectias 421(e) to sttbjert toacivit meterMedirnro and,°nrcrtists State heattin care peoattyofop to 511.000 foreneh meltplms ssderuerniotts 120(n). I 20(b). paynnrnninrolved,tt92. oct56 oftine SoeiaPsoeta’th’Aeo.The enctusian alto applics to alt othee The civil money peonaltien provided forE.’cecativr B ranch peecorooncot arid non’ nadee Sections .12 (c) sad 427(b) nrc to heproctnrement programs and scn’,vi lies. hnpooed in nbc satre matinee sooth Cr riviPiarlovuro eftht 015cc of toonpeecor money penalties imposed porsusontoOenerst Esetosica List to HRSA in under Section I l2gA oithe Soeadsecnt’dryAeo,anthoriny ofsertios I tOe(s) ofthe Sor!ol 42 U.S.C. ti2Oa.7s. Regnlslionn govemineSemrOos, alto. 42 CER 401.105. and the civil msnov Pc sallies under Section in 281,eonlt’nrtteexreptios ofthe Proeorvalo’o are sett’oelh at 42 CPR Pan 003.

snpmsbs, rain mc’

REPORTING ADVERSE LICENSUREACTIONS

ireetwnoa,

I

Ctn;goos

Hnspilalsa id Other Heallb CareEntitles

lheSoceetoayofl-lHsssillcondtntasinrealtgniien iftheee is reason to believethat a health rare enilis has sohtiantiallyfailed to report required adverse aen ions,If the insesnigatioa reveals that the healthtare enlit has can eonrplied with NP DOregidasiona. the Secretary will provide theettils with “titles nalice detea-ibieg thnnoncompliance. This saTitenretineprovides th eenlily wills the eppsarnnsiny nocoroece Ilie noncompliance, is ‘scOotnntifiesitnfitstieh,larequesna hearing.

A reqanst foot heaeiag mnnle000tn aslatcmentofdte maneeiat facinsal issaea iii

dispute to deninesseale eanae foe a hnaaiaeand intitat be sabmilted In liftS within 90da3 soC receipl tfnnliee ofnennamplianee. Anetaniple of areaieeial‘extant issue in dispatch a health care

- a entity eefalise tillS ‘a claim that the health

cart cathy failed to meet reparliagreqaleententa.

A req lest ion llcaninessill be deaied ifilisunti’nely, lacks aslalementofmaterialfactual issues in dispale. cc lithestalementia frivotnas or inconneqr’eniial,Hearings are ‘rid itt Itt Wnahi’ielan, DC.metropo hIts area.

tHUS drleenaiaee ‘hal a heal thoareennilyIons sabatatalialty failed to reportinformation in aecssrdanre sviilr Tide IVreqaireneenta, the name nfthe enlist willbe pablisired in the Feekrsai RegIster, oafthe cathy will low the imnoanitsprovisions of Title IV with reapentlaprnfessiaaal review aclisities for a periodof3 a-roes commencing 30 days icons thedale ofpablieadon in thr FederalRc~later.

Scare Bnards

Slate mrdicnt sad dentnl hoards dial fail toeomptvwith NPOB reportingreqateemeata tan have the reapontihitity Inreporleesnrvrd from them by theSmeelnes’ of HHS. In iecir instances, theSecretary will deaignate another qualifiedenn4tytaacpomtNpDm tefemaania,i,Stale medical nedrnlal bonrds donrimeerTitle IV eeqtircmennswhen nlmey fail toreport lieensnre diseiplinany aeliattsreqaited Is be reported in I1trNPDB or failto notify OHS ‘sIren they ateassaneahealth care entity is failinein reportadverse actions it has laken atninsiph)~sieiaI’saItd deolists,

When an HHS iavtali ganinrlaabaloaliotessash’ rcpartu’tg failures, asvritten tatter afinotanntnpltaece is scm lathe Scale nardieaior denlat hoard. ThLs notice allows Statetoedical and dental hoards an apponunmnitvto conner the situation, lithe Slatemedicti or denial boord fails to complywith the Ills notice, hen IUIS willdeaieaale antallirr qnalified entity foerepneOangIsalbeNPflln.

l’eolesnianni Societies

A prsfcaeioaal sosiely that hassnbsraatiattv failed in report tdvecaenaensbceahip neliattn eon tone, for 3 )-eaes.the iolmnni13’ protections provided andrelisle fV foe professional review actions islakes againnl physicians ,itd denlials boreden theie professi anal tnmpetesree tadprofrasintool condanc.

flit Seerelomy ofHHS will casdnce oat

insrstieutiaa ifthrre in season to believethaI a panfenaintal society Itassubalantiatly failed to cepot ladoeaseeaeeaberstnip aelimna taken as resell ofprofesnienalnevmseaetnvtly.

lithe inveomnann’an revaals that thepeofeanianal society has nal compliedwith title aV repotting reqoineusenit,HHS still inform Ihe prafhssiam] moietyof i Is neacompiiaece ha writing. Thiswniten notice ponoidet the prafesninnatsociety ssiih nltr opportiaoily in canonsIte noncnnnptianre. as well as anti fits II

ciba eight loreqaestoltnaainn.

Areqaentfora lIeas’argmasltnamninn,sialomenn ofthe material factual lames indinpnaelo drmnnstate coaae foes hcaeinpand mIni he submilted to HHS withia 30days efreeeipn nfavtice of

annomplianee. An exanspie of an,aten’aifaciaalissne’m diapnnleinn prnfeoninanlsociety refuting OHS’s claim that diehealth care etntitj’ failed lent ret nepartieg

A eeqnesl feratteatiog icdeeied it’ii ismnttitmtelo. Iachsasnalnmrme ofaamatrrialfactual icsnes in dispule. or ifthgataleosrnl is ftivnlatnoriacnnsrqaentiah.Hearings oem, told in the hv’ashirgtan, DC,etalrapoiitai’ area.

IfHHS deteeaiars that a prnfeasioatntuoeteiy has sabslantially failed no reportinfneniationinancerdance with Title IVreqnlieememsts, Ihe none of the entity willbe published in the Pedant Regiaan’r. nodthe professional seehely will Instinonanity provis’mansa fTille IV withrespect In prafessinaol revies’ sniviticsfora period afj yeaeacommenr’me 30days from lie date efpablicatian in then~’ederolRcpooer.

Q nestions and Answe.s

I. iinwlonenrc repnnnlrridinlheN PD Ii 3

Information reported to the NPDB ismaintained penoaaatentty atiless in iscomeened or voided from the 5551Cm.ACoeeeatinnneveidmayoatybesnbnaiecd by the aepoen’ata colby’ ordirected by the Secratsen nfHHe,

2. Csomynrean’,aalinapcaaidencnpvsian riPDB ‘gao,. nellie snhjentpeaealrlnoer?

Etc NPDB appreciates enninimatlempt In maintain an epema exchangewialt sabjeets, Hnwever, ifynoprovidearepa-ofiherepoat in nliesubject, be sate to remove or cbliterateynnr oegnnizntiotn’s DI3ID. The DOIDshould aemain confidential io tieornsaainatinutonsltich it is astigned.

3, Wi, nreea it mmd lists niAdveessAnise ClassificatIon Codes. BasIsfer Adams Cedar. and toatlneacliecAnt (5) or On, ‘esinal(s) end oat

Adverse action ctasuifieattcn cedesnod medical matpratnireact(s) Ceemission(s) codes ate presided inpopup isis is the respectls’n IQRSweb inpnlsnreens. Eteseendesulsoaim fonnd in the nppticohie innerfoneControl Dacameel (lCD) hat inoeailohleonthe NPDB’iIiPDB

£‘30 sepaambmtatt

tSas’te,n espoth aio’isataa,bmt

~ cotnpia’tnt cvi II,. feresasepte.a Stareboard, and a medical moiprandee

4. lam rhenewaur hnriz’dsnhntieter pavmenrrcialts, the payaaenl mum befor a medical matpnaciiee payer. i repnnied to the NPOB,Fonnd snime dncumeulnuian ofpaymenis thai sn-ret‘see repnroed in 7, Hns’ does a nredieal teal practIcethe NPBB, ‘~‘hnl should I do’ payer rrpnrt a poymoann ire total

amnnul has Inn been drierreinedlithe payments were etude once alter and tine payer is stare ne an initialSeptember I, 990 nba, he NPDB partial pavmc.nn?opened), aabmit reports on thesepa)seents to the NPDB. the Complete the MMPR streetsregninnioits prescribe that any enlily according lot nbc inslenseti nan on thedial foils 10 report a paymeat eqs teed tQRS. Mole the amnunl aftite firstlobe reported’an sabjael to neivit paynneal and, in the nneeative secdnn,money peanily ofap in 511,000 fee enplaia than the blat ontoant has mteach reich paymuenl. Snbmttthg nepnnt been determined atid the first paysleatlhmaeh nbc IQRS and lien send a sap~ial payment ~lTca the finaleta to the MIsDO thai esptaiea the amnunt is deteemitted, sobtail

niecamslonre ofthe repnathoing Carrenlienna Ihe slUr] report, andaebmteed loin. The NPOB ‘viii nero the fiatl ar,aeunt In the rtaorutivemaintain this infonnamiao for and it secniae,punpoten.

t. Slmonld paymess eselnsWnly mr she5, As a medical muipractirn payer. 45 benefit ofaeiisie nr hnnpinal he

I have in rrpnri payments made for reported?a deceased nahjcel?

Medical malpractice paynteets medeYen. One ofthe principal objeedees selety farahe t’cnefii efaclinte oraf lire NPOB is no reoeict the ahitity haapttat arc nor namently repnstahte Inef intcompeneatt pcae~linac~ no move time SeP00,iron, Slate to State scishons diaelosarenftheir previous dannmsgiirg or 9. Oar inoara ace company reimbursediacompnlentpecfonnaanee. Prnaduient a praroliloner foramcdieanproclitiolte ma slay web Is assnnne lire eaaippacnlce payment rhndm1113’ efa dtcesacd practitioner. practili one.’ made Sn a patient. ts

thks reporlahie?6, t,Iantawri Inca coanlilaini bn

directed Is lie nab~~er ci led Is she Yes, An innararlee company rIta.claim? re’mabees esa praetiuirnee foe audi a

mo, metal (mahea a pasanent inNo, The defini lion nf ainedm’eal response La the med’nan matpeannitemalpractice complaint inctades claim erjad,ement) most report dm11complaints “brought in any Stale or pa)ment In he l’tPDO, asFederal clans on other adjudicative patient stmhtailned the demand ittbody,” t f~ police files assea’eea soiling.

Eta OIvtanbo, tint

Snpostnr1aOi tin

scan thawaaa ci,rn, v iarsei

It, ifs patient ma karat neal demand t 3, yb ties arc the et’pnrriarnfnrnrefnud fnrnersiees,’etimo enqu’nrnnrenls faennlf’inuarrd en”rnsnilitsg payment repnnnbie in the players whaprovide professionalSep00? liability coreea ge roenheir employed

prnnnit’mnaaera?Na, Only pnymenls resnining fromss’eitien demands are rnportable In the Employers who insure theirNPDO, Been ifehe praniniearr employees mast repel? medicaltacnnim the damnmd in scuba no tht tataiprarnine payments thea- make fssr

medical maalpnnclite payer, sIre the be noun oftheir empteyrni.paymenli s ott reportable ifthepatinnn’s only den, and n-na oral, 13, Ifa alipniatins nfseuulennenlorHawever, ifs snbseqnrnnntiaen eaten orsner requires I halttaienor demandiseeeeived from the eemoiu eonEdeaiial, howdaes npolices and rosnita isa passnest lIlac ,nediml mal peoeaiee instate rrpnrapanarenlis yejtolable. the pnymest lottie Ni’laowilhaan

nialatilne abe aelaierraontaerdemeneII. Ifaaindividnnl pradltlinneetsont urenarloeder?

named ian a medical mal practiceclaim or camplaiar5 hot he iacihily Confmdeanial terms safa actliemtai oror praclilinner grasp Is named, jedement d onot exeate an entity tramslasaid hr pavmenr hi rolaorlol? 51 me staletos edqoiremoeltl In nepsast the

payment so the NPDH. The reportingNan, sn, there sseeplioa. tribe tanned entire should ercpla’ ti illsho naeeolivrdnfelrdacn isa ante piaclit’tenrr sretina ofihn hlMl°R Ibal theidmntfled usa “pmfeasieaal snetrmentoe court order slipelllescolporndoa.”apaymeat mode for the shot hr toenna chime scitirmenl antprofessional cotpor.anl on melt be romlfideotial,rnporied for the peactilianee.

Ii, s rrhcre Isna medical anslpeaeilee12.Assspen”mnn’ peaelil’inneeio named ptsyaoensan d Loan Adjnuimenl

inaaaeo’ann based on ihesenicea of es1menaco (LASs) are paid is ordera anbordn‘tare practitioner. glass’ do no relesise ar d’vsmivoahealilieareI repaet tIne snpen’isw3’ pracrilloner foam a n,edimllpeachiliuser’. malpractIce soiL ahonid the lAS or

reported?The report on the snpers-isneypractitioeerabnatd he snhmhlnd using No, IftAliaarenothnclndedia Ihethe same Inalpructicen hails deocrip’ medical malpractice payirent ohmties code card for he v’mbneditrnae. Ii try siton Id out ho reported a ItteThe report’tog entity may provide ati NPDII,enplanailen that she ncpcrvisor~’praciiliaaerssas named based en thesnbordisate pnacsiol once’s ,elsites innhn nannanice drteriptira.

iqmsb, TOOl 031

ricepIm le Oqss,rOwner c tojnou

6, When reparoiogamed’malmalpractice paytoto I. ohoold hesstadjanloaeorl enproses ho inoleadrd in(hr paym eta aneoun I?

tARs should be reported oem rflinypan ritho medical malpmnlire

pa’nrrnn. Reporting requiegosoettainclude lee toad amountofohopa’ment and a description and aoroustofeii,, judgment or settlement and ooyconditions. iochtdiog terms ofpayment. LAOs should be itemized inlien description section ofthe nepon,LAO, rofrrto expenses other thouthose ito compensation sal ujanel.noth as attorneys foes. hitlable toots,expert mucous fees. doposiiiee, ondteanurripteosis. tfLAEsoret,otinotoded in the paymeott 0000aet, the’need not be oepooled.

• I?. Arepas’meneomadoforlttehenorto

orresidenuinterns, nnd studentsroportobte?

)°ayt000ts made forilte berelot ofticensedrosideano nod istorer, oreroporiabte to the NPDII;pnyesteootsmade for tho bonurta ofontieemedooodioot or dental otodonts art 0,4

reportable to the NPDB.

Ropotiiog otdro’Se Lfotstttooe Actions

II. ttotcohnntd a Stab board report on000ton mutt several cods orcompnirenrs, for instance, 6-mnnthlicense sitspetonbon followed by 2—year prohaoion?

The booed sireold reports the node ofthe p elm ipal sos elton or a onion anddescribe lea full order, loctadirro tosserantisos. in the oaetseivee fthe AAR,Ao additions] report in tot necessary

ssl,eo the lessorimplemeoeedsio5-einwaoinetudrd heihe donosipsios in the Initial Report.

19. llonvahooldoSeoce toedienlordental beard report aeoiootnrsleooolienaeoohar~edl.ynoraeI order’.

nrc brood slosotd reporn the initialadoerscaceiem as ttsool; thejodiciutdeetsiroisroporsed asaRenisiontoAction. Foe csatnplr. la boardrcrokcd a physiniao’o jocose nod ajsdioial oppeal resatteot in rho eatenmrdif~ior tite disnipliee to prohatioofart sean, then thr board oootd beroqainid to reps’s both los itiliotresocalion action nod the courtordered rcvisirs too I-yearWhene a court sloys a board’s or.dor,thisacoins may be reported aso

eleioiott to Action. using the A.inorseArtion Ctassileratiots Code forRcdocdoo ofl°revioos Aetioo (12951.Whet a 000rxoveetornsafloard’norder, the Board ohoatd void theleiliat Report.

20. Wlronroportirsg areprienond layStain licensing board. wlral LengtholAerion shonld be entered on therrporl form?

The indefinite block sboaid be niorhod0° the oppeopriale ertaoecsrrers in theIQRS for mpnissaodo reported oa tireNPOB.

21. I fore rerolerapraeli riooer’n clinicalprivilege, becoose ItolosI hheilter Ii reese. do ‘no report (leemt no, lion?

Adntinisoratiscannioos thou da 001involve o proressiosut rosiow artiestrue not reportable to the NPOB. On]yaotiors resulting fovea professionalreview aod tastiog route ito’s 50 daysthat ore related no the profoosionalnoesspe100co oe profgssiooal coodont ofo peoreiti000e shoold be reported no tireNFDB. Thus, iflhe ors-roatioo ofo hoieot peisilege, is oaeoarnoir. theaction ottoald not he eeitoded to theNpDB.

22.a~end’gncactions on clinicalprivileges reportable prior Irahearings?

rIce action is not repot’nahle lentil it isnode renal by the Itea ith rare entity.An exeeplioo is made ifas immediate(that is, nolmrnrany) seespoosiot ccroslriotionsobjeeltooohseqoteoxsolieo end heoniotg is rolowed beeooseof iosealneot dangerlooerindivido,d’ohealth and safe’s.

A notetetany sospensiooceeertisiratprivileges a neoroutittela’ cnrtsiderrd areportableeveot. Hosserer, ifssomtoarv anaspennion ants eager thaat30 days nod is coosidered by dteItospital or other beatth true etraits tobe a professions] roviewactionscans tlral mm In delrttrd itt Olinorganiaatioi’s byta,ssi, ihet tire erdn~’ttloscteowent otto sosomary tospensirm

tithe reported nosaaeeesirnissubsequently altered fot ios’.’og abrosior or other proeedorrs. the ootils’00051 snbmio nRrsision In Anti ott ori’eid.

23. Are adverse oclion, onpris ilegrs reportahtr prior toappeals?

.hdsoeso actions on ctinical pris ilogctare not repaoeable soul they are madeOoalhsthohoalttrcmrtrtioy. funi,rteoeal adon’mistnatire appealpeccodieeg float action by the ertity ispounded frc io the etetily’s to lasve.Woo the acnioo is lout reportobteetatitcite noontasion ofthis nppcai.Howes’er, ft prerirasly reportedadcc~oact’tonissobn~neotlyosodir,eol prsaeated alice no appeal bythe penctitierece, the health care muIris tespaoosibtr for aobtointing aEesioiro In Action or ‘oid

24. A health a re entbtvloohaoadsro,oarcia nagainata peactitlonor, antthe acli on muon enjoined beforottess inrplemented. Shoold theactioo ho repined Ii be rs’POll?

Ad’•erae onions ore repoa ohio atly ifthey ann neffoot foo ax Irasl 30 dayt.o~o adverse ant ion eajoioed prior toinrptenrrntalioa shanid are heaepuned. Howeror, if thg ads’ersoarli set less boon is effect for 30 ornIcer days nod is then ertjoitreol, theadverse idiot nhoatd be reported otdthe esjoianteoe shoold be reported asoRevisian co Action.

0.52 raseombostyao

Uaplob eaton ueoo raaosssti

23. Are lnvtsllgaoionn reportable If ehev 22. bOone a hospital or other bealih caredo eel reach a coarlosion? oolilyrepo en od scene oelioos

eeenceroiog (he elitieal pra’s-iloges orlnresligatioo,are net reportable medtenla od nleolal reaidenls andevent’; trotnener. ito pooenitinoer ‘interns’.stanreaders or fails to renew olinicatpriniiegrs, orilpos’vilooesora Nel ifnhe action wastatneossithietehereosrinned while the poanltto’ once is scope ofthc uniting proonar. Stoneeither codOr ion~ig1tiao by a lrealdr resideots end memo ore Iraine050’score entity for possible incoeepe tm000 gneedaale hrolt]t pmfesa’eons rdonot’tooor bseproper professional conduct, or progns,ss. they tao coo geaoted cliutsat1° asrid on insesoigotiort, ohr paisitggespoear, hat are aartsoriecdouocodee or resaeiccioo moon be It,slhe sposoorior instilotios toreported to the NPI2IO. petfono clioica] datios and

responsibilities ssi thin the contrst of26, A prarlieioner he taoder ltsnesligatiun their ceadaale eoloeotionai program.

relating to pnsnthie Incompetence orimlaenpce proresni onal eons] err and loosseser. aresidroloriotenarrnayresIgns feoto Ihe Itoapital. Ifohr peaclico rotsidethe aeope oftheproelilioner do] tot receive foonal geadsateedrearins program,notibicoilon of he r’ttvtstlgalinn, in for example. mooslighting is theala Inureportable floor? Itetensise Care Utt’tn or Eattergeocy

Departnrcoo. .Adveescrliaicaifledor 01cc pronisioss olthe ffeolsh prinitrgeaoceiaos retaled no practiceCoot Qoolsosloepronvreotte 4cr bite mc~io~roots’td0tbe scopeofopraniitiooerisxaireqeeirrd to leave formal grad onto edocatiaoal porgeamdirect bstowtrdgcofthr ins’ostigadot. arc topeetable.Hoopitols shoatd hot able to produce

rvidotoce ofait na-polo0 investigation 20. If onini riol apptiratinn forelisicalit tho ovettt of qurshaning, See dre prOsilegrs he denied cc the privilegesInvest’taationts~nion of thin chapter groaned ore naol-e limited that theseform ore itfoseradott. requested. nansn Iii, he repotoesI 10

hr N’l°IJll?To be considered reportable.practitioners rosignati no macc be Yes, ifitne deniol or timilanian ofceo dcred “is order no preoeun a privileges is nho rrsatx ofupeofrasiotat ersiew action. A professional its ions anniatt and isreoigraxioo terdered with the reionml to the practii’eatren’oooderolood’mg thaI lee hoopi tan on ill prolessiota] competence orcease as ioevostigaoion or pcofcsoionol professirnsl oondstcl.ros’t’ew aeiiooisreporable.

c.sa sarlaml.oatst

soptssber2lot r.aa

Nraatjdsotocb

20. 1! an °tmpnlrod lnrarlictoote’ennert assinlance. lion arslhoe’aod hospitala rehahitirution progrotu, is it slrocial1 sonic to the CEO orreportuble? Oestarlntenn Chair, directs the

prueeoeionerto g’‘yr upelinieslIi to solo ntoey rstronro alan privileges and eoberu reltabi tiluliosinrpairrd praclstiar,oriotoa Itmooram or face iusesliealionrehabilitation prageson it trot eelatlog no poonsible professionalrcponable to thc NPDB ifto i000mpetooee or tnrpropeeprofessions] review notion vsos totoen peofeos’mr’aI coudeec, isaod dee pmctixinner did tot retiaqcish ttsrrondee olel’miostt privilegesc tinieot privitegra. Ifo poaceioioter reportable no olre 51000?rakes a tease ofabse ore and ctioi rat

privileges haveuecbeeot alien am-ny, Yes. tfttto hospitri CEO d’erects theth to ‘to orpon to ‘tsr NPDR he pmctinisnerIo sarrendre his or herrespited. cltstieal pnnitrgos m fact

investigation by hr trnspitot foelao impaired practinioetcris reqoired possible prolossi aml iaermpr001ce or

bye profossionat rovirw aceion to improper profennionsi hchssior, nbcinstlon tarity toter u rehthitioorion suueeetdrris reportable no the Nt’DB.prog005s, obe professional rrs’tesr Tie rsurreeedee rfci’micol peini leers inaet’onn’s rrpeneahtc to jet 101000 If it oscitange famnot ondregaing anis basod ot the procd loner’s e’acusuigauioa sinners a report no thepeolessionn I oompcltoce or 101000. regardiess ofssi,cthortbeprofeuoi ooal osodeox nod ndreroelr prootideocr is impaired [see (60.9alforts thr peacritioner’setinica5 (aXONA) aced (B) oftheNPDBprivitoees formore tha,t 30 days. rogsdorioetsj.

W heae rotept~ine the 43cR iopeoi 31. Lasos related no dreg ooti alcoholscrcut, the reparn’mgerditss can seteo, Irratoreot t prograots haveon Adreone Action Classi location eonl’sdenttaliov prnvioioos. Won’t aCede of’Other” an,] csptaia bet nice cc port eoteerningn poaebiiloner int,mratin 0 thai the pra~tinner’s a tre’atmenl proernms’.olale Oltosoprisilegesoyteoresnoicied or proven ions?suspended because ofnooceensrrgardiep qoalixy ofcare. Entities No. Only thradvceseaceissafferlinpmay slob no oonsolx witlt their lena] privileges must be reported; the factrornuet rcgarding,ttewording ofntor that aptantidrneeesterrd a treatmentnanroniete before ills sobmitted to dre orreinabititate’o,, proataaot shosld notNieflO. be reported. lfonly the odescese an don

is reported as reqsieed, thorn is no30, Anaimpa teed peacrilioneret violation oft ass Eta~ to dnag or

ntrent bee ofa hospttol mrdt‘cal ~t, ft alcohol troatmeon (42 USC. §290dd.3has beeo repeatesaly eneoo raged 00 and 29Eee.3).contra rnhabilirnnion program. Thepranlieioeer coibi000s to disr-e0ordilte hoop’ loIs advire and oO’em of

stposbrn Cost c-tea

Repaving .4tA’e,so CPo’ttkol J°010’i?egesA dm0.5

dial0 r arpoisi

RrprningAdrene Me’.theral,ip Art/oar

32- Ira peolhasiorol satins deniesemhershlp to a practitioner. a ii

reportable to line NPDB?

The action ‘oust he reported too theNPOB if the den lormeirineestripsnas based 001profeasirnalresiewadios conducted through a foossalpecercsiossprasesuandwas hu.ccdonas assessmestl of 11°cgsrofesuioeal colopctetsee 00professional cooductss hit/i affected orcould affere the health nod welfare ofa polled or patients. Dosia] ofmeusbersiiip forreasosls .ini related 10professional competence orprofessional cosducasoliich afltocts orcould adversely affect line health andsafety nra palieni (adserlisia0praclicrs on ret nlmtltrea, raeexamplel should rot be reported 10 tile

-NPDB.

— FDs~ Opus csro,in00,

Tile Dispute Process

The NPDB is commilied to mainiaisinouecueuteiufursnaliuoundensariiigiliarhealth care practildoueea am iufomned‘shea adrecsc actions are reported aboutdraIn. hvhenuhe NPDII receives s orison.llielQinsprocesseatheinronuauionesaclly as 11 in submitted by tine cep001ioeonus.. Repoeliup antilles are reupousiblerorshe ucmwacy ofthe information ‘heyreport

Wires he NPDR ploecusru a report, aReport I isrificiuitoua flacaaoieui is sealelcclronieally to alto reporting entity vialine IQRS ondean he accessed so theReport Saetrarsceeeo. A ,Vor carson, rioRep.arr 1,111w Data Banakfrj ii mailed Ia hesubject. The sahjeci should ret/em tl,ereport for accuracy. ireludiag untilrnformaliooasrle000lrddresa nod placeof cmploamcoe,

Sainjecasmayauesolurail changes Inreports. rosy iufrrsnaoea is a repeil isinaccurate, the subject most request 11151line reporting eelily file a eerreesdon 10 therepel]. The NPDB is prohibiled by lawrena namliru tug isronisutias submitted isreports.

lfnhe eepoeuing duly declines sa chaogetIe capon], line subject may iuisia,e a

dispsae of she ergot] linrough the dispuleprocess, add a stalemcan to the report, orboth. The dispute process iu nal as aerate10 proleai a payment ur to appeal tineuederlviogreasonos ofao adverse achesaffecting line sobject’s tense clinicalpeirileggo, oar professi tonal societymembeeship. <either the recoils ofamedical malpractice claim nor theappropriateness of, or basis roy. as rdve,seaction may he dispaoed.

Suhjeess wino wish no sddassalcmcnl Isart/roe dispute the factual aecumey amropoaa should follow tine iaatsuclions onthe Kot!flcon/oa oft Rs’pnsre n, the DosesBaak(4. Sabjecis who do lot have lineorlamsi ivolifiessldaa ofa Rrpart in thefloss Book(s) may obtain a Sub/aceSeaueo,eeea’tdfllspaoc Issliaa”o,u reamfroze nl,n NPDO’Hlpomss’ehaiteaisnnuropdb,h/pulti_ram’

Subjs’ei Sualemenas

Tho sshjecl ofu eyed may add aslanerlean to the report at any rime. Ivinetthe NPDB pasces.’el a srsleiarnt,oootfutation onto stalcincri isaeot 10 allqtrrienssvhsrcceis’edtltarepans, aed isincluded with ihe report svhrnisi’sreleased Ia falure qaceicas. SushjeaiSsatessenns ice limited ie2.0l0 ehameters.ilociurl’asgspaeeo and pmrcttaauiao.Dersiuiog a ilulemes’ is acrordoriec yvihla

dial thestatement coalaius the inreen,aoiastsubject deeonstsosuimpoeloto. Alltiiaeaelers in eyoud 2.000 ale ursncated.Sabjett Sisiemesin csateal ‘melede anytames. addresses, or phone tumhers,inclodiog those or panieeis.

A Subject Slalemeel is paalofdue spocil’tcreparn ills flied for. fIne repent ischanged be the reporting entity, thesuulemcntatlariuedto Ac ceport aiss isremoved. Ira slatensean is needed ss’ith linenew repeal. a new atahetteot thateereeeacea dir Data iis,tb Control ls’us,hor(DUN) of the sew report msoebnssbssitard.

Sabjree Disputes

The subject urn Medical Mat practicel5aymeti Repent (iIbIPRI scan AdreeseAction Roped (AAR) nay dispale eithertile farmal seeusnny afnl,e eepoet orsslseilaae I repess sos submitted isaceaislaeee with the l<i°DB’s repoeioereqaiseoneuls. irelading one eligihflity ofthe estity eo report else infon,aalisn 0 theNPDR. A su’bjeei may unrdispulerepoel ianrder Is protest a decision madeby as iaiurerto selli etetaiou oricappealthe onderlylog reasem rrr an tdverse

irs sabjeci hal ‘eves that ina’om,atieo inrepeeu is farlually istaeeeeate (er., asiecerrecr adseose action code or paymentumoeslo) or should not have heel repented.(e.g.,uelinieol prtrtiepes artist thai last,30 days or less), the sobjerl ansI astelulpatarrselse tine disagreement directly-withline reptelingeetily. Changes lou import

be,ubmiuued only bythe reportingenlii)~

hvhen nut NpDa receives a ploparlycompleted Sehjoe, Siaie,eeet sad Dl’spaucInitiation rorm Does the subject itiujalise adiopate, netirsealian ofthedispaleil stilt15511 queeiers wins received line report andis in ci aded ss un the repeti ss lieu is isreleased to (store qseeiens.

Ab dislunle become, part arlhe specificreporuitl,tsuieoliog. Ifihe report ischanted by line departing eull’hr. thedispute tiolalion attached to the reportis also eemss’ed. I rubesabjeen helie,’asthat the ness seeslon one the report/arsensnallv luaceurair, he subjeelmaslininitle a arts distaule.

There are litre psossihie oateeetes for adin paler

‘nrc rapo,l’tusg rulilyeoereels the reportIr the saiiaraeticaardseusbject.

• ~terepanile entity voids the report.‘hue eeponie,e mu ly deeliees to chargethe report.

Olupaute Ovorpluw i or 2)

r,acale.arouotsI ‘505 absleatassI’ sss..ehresuoI’ Os*secrsuaaasotsrazeI. tiwnssosnlogOO

‘fl5nCs~ea

a—‘Oaths atOem000a

costa a

senasobre audi P.1

Thapan I Oaeotn cantor honesscene Gsvsa,5

( tnouopflI Ranitne

a, Cnesthsa cc~y~bgRnco1

Sccreta rial Review

lfdte reportine enlicy docliocs to changethe disputed Advetse Aeniott Repart or]hiedieol Malpracticelües Ito oct00. the subject may requesttint the Seceetaey of HHS reviesv thedisputed report. The Secretary tnicssidisputed reports only for accuracy offactual iofunnation and to rosIn hal lieinfooanlation nut required to be reported.

The Secretary does on’ revIew the sterileof umedicat maipruetiee claim itt lhe clueoft panmeot or the uppropriaieness of, orbasis fur. a bent 0’ care rentity’s professional review adieu era State licensingboard’s adios.

TorequnsnSecrenarisl Reviewofudispoted report, the uubjecc musnsieu andreturn to the NPDB the feeserecaboaaJorReslese ufolse Disputed Reporo by fOeSecreeory of the US. Depeaeome,o ofHootelouaatdlhonuonsertieesaloehcd tothe Report Re,xse4 bbidedj ovSoceosaChanged docamenc related us the disputed

Repora inoerurate Os Suheejeted

if the Secretaey cocclndes thot the report islice Secrelasydirect, the NPDD

no correct the infoemanist in the reportThe snbjcet ofnhe eepotn, the reportingentity, and oil queriera ‘rho reeeivtdltoticeoflise disputed eepart ore each nedo Rcporo Ree’iso4 r’ohk,tior StuntsChottgoddoeaatseol infereoing then, ofthetoesectioo.

Ifthe Seereltre coecludes that the report‘san submitted in ernsr, the Secreonydirect, that the eepenl be raided from theNPOB. The oshjeec of the report. niceeepoeuiog entire. aisd all qoeriets us Itoreunited notice of the disgtoled rcnmri areeuchsentsReporakercse4Voideef,or.SbttttorChoat.geddcscoeeesn iteefornsingtltemthat the report has beet. voided.

report The dispale uad anynaeotnpasy’o.odocuntetttatioe nuust besent no the NPDB, nut directly In useSecrelarv.

site uutsjeen also cost:

• Stole clearly and hrittflyinvsritingwhich faces me in dispsle and what theaubjeet believen ace the lads,

• Sutotcit dneuuteotation eubsu nthlicgfitot the reporting entity’s informationitiosccotoie. Dscumeniationnessndirectly relate to ihe facts in disputeand stahotoedolly coatibute toodedeeninalisn ofthe factual accuracyel’the report Deecaceotatiosmavexceed it panes. includingattacinsents and exhibits.

Sabauit proafthai the sebjeedaalennpled to restive tlae’disogeaemenlwith the reporting mu ty, hccunsucceusfal. Pvuofmay he a copy ofthe sabjeet’s cortespoadritce to thereporting emily arid the rout-sotspocso, irony.

Dispute Outside the SeetpeorSrureturialReview

lfthe Secretary eotec ladcs tbaLthe issue ii;dispute inoutside the scope ofeeviess. tinSerretarvditecns the SPUR to odd onceslny to that eileen to ihe report and torcntos,-enlie dispute colaoioa from titereport, Thessbjectmavttetn submitwithin 30 days. c stanenseet trot it addedto the report. Thn state meat is limited to2,000 clearaccess. including spaces and

- aed is enteted into the NPDBcosnputer system exactly at sttbmiaed. ofsonese Subject Statement is received. asyexisting statetsreic previosisly suhmilced bythe subject is nta’mtaioed as part oftheretmec record.

The subject ofuhe eeport, hue reportinguctity, and at queeicrs who receivedtsoticr or lie dispated report ate each setita Repsss-e Reutsed shorted or SrususClotsgeddoeumecnisfom,iteg them oftheSecretary’s decision,

• tb’aiu3odsysiromthedateeficitiatisg d’ocussions svith thereporting nastily before requestingSecretarial Rnsiew torepeehiieeg eMits lime ho respend to thedispute.

Pereiitent Dorumen taunt

Ifthe dispute retains lot MedicalMal1eesceire Payment Report, penitentduetatrentatlan mifle ineleden copy ofthe fnllss,iegc

• Weiltetscluiea,• Seitleeseni orueteuse deetmesxt.

Costnjedgnsecs.• Written fiodiogs of tahihatius or

a hematite dispsteeesolttieaprocesses.

ifoecessaev. the Secretary silt ask thereporting cutik’ to supply sddidenalittfonnatioueottftrntinr thor the report stansnbnsiatsdinsccordatnee with SPUDregulations. Entities teats respond collieSecretary’s teqtcsn farmoreeiffoemattossvithio IS darer. After eevirtvitsg altdrenmeolatiers retated to the diupule, theSecretor’s will dalensine whether theicfoetoata’oaia the disputed report inarescatate nod shatnid hove been reported tothe NPDB.

If the do pole relates to an AdverseAction Report, utereiam C dueunt entatitettt’igl’tiuetudeacupv eflhc rnllosvittgt

• The findittrt of face sodrecotnunecdatiess ofthe heahit careentity, peofessissont sodrtv, or Stateteens isg booed.

a The d’etat report of lite hcaeisr panel or

othrrappeilale bodyspuans hich thedeseriplias ofactu or omissiossssusbased.

Senevlarial torsion Results

When the Spoil receives prapernssiee ofateqnesn far Sccrelaot’al Revienv,tisematerials ate foannavded to tite Seceetars, ofilHS far reviess. There an three possibleoetcuates foe Secretariat Res’iesv afadispute:

• The Sceactany coectsdes that the reportis aeeutate

Secretary concludes that the reportis in ace a rote

• Thu Sucettar. couciades that deeissacsis dispute Ste outside the scope ofSecuelatiul Reviesn’,

ReteoeO Accurate no Submitted

tribe becsct’.n’ eaestrtdcs that theinforutatuon in the report is accurate,Secretary srudt an eocpl000iioo tf thedecisintn to the ssbject. The stthjeet lotuythea scbmit, within 30 days, a snateteenttitan is added Ia tire report. The stulettesinlitsitcd 102,000 chatactera. isuisdinespaces and puntaottioo, usd in tutored itetothe i’lp[3R eotnputersytletn esac Dy asstubnnitted. The rent Subject Stuteorrenreplaces any snatesnenc tier ssbj eenotbonitted peevinnity. trite nest SntbjeetStunemenlis received, say esistitgstoteasntnt ponsietusly sshmitted by thesubject is maintained us part of tho report

The subject ofthe repurt. t lie cc povtiegcnticy, and all qeeriers ss ho receivedonce oftht disputed eeponaee each seolaRepec-tRet’ceea~ t’o!dcd.orSiaaocnfltatsgeddocuuoenceottiainiteg deeSecretary’s explacaciou and the tuabjeet’sstatenuenc. Fcuurr qorrirts nv’d ircecive theSecretary’s ted subjects ssauemeots withthe cepott

Dispute Ovorviow lOot 21

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Reeonslderatioe nEllie Secretary’s Exatsopita ofDlupetesDeeistons us Disputes

DuePreuens-AtlegedheeteiAitteos ph HHS does set have a fenonatoppecain process I’or recess idgrntieo oftire Esemplet A practitioner uttered bat noSecretary’s dgeiniaanon dispotes, IllS eels,,, during protbnuiesal renters denieddoes mv’senvsueh requests. ‘site sub.ioec the pmctitt’eeer doe process because nbccost sn:bmilasvrtttes request for ves’iennees igtered t tm lesliutosy of

oeeonsidtaation to the odOur thnt issued she mcd’ cat espe015 or etherscilnes urn entiedSccreuanVs detecoss’tcasinsn. The subject so prove various points the prartitiener reinshould be spenirte nboot any ass importon cto toe dcfettse.igonsottios that vs-as anavatithiera thetime rfSccrctaeiai R eoiew nsd ns hach Ouieemc’ ‘site Seevuoey detcrtnitned thattusnes tire ptactiliueer isa haves stern not the dispute request nusetta ide the scopeuppeepsiatety cossidered dante the tevtmtv ofreview’ tad made 05000’s, to teat effectptecesn, ‘site Seuertaeywili eitheralrtsts in tita report. The dispntanutalistwssthe prior dclcnoittacios eriustearnvtsrd removed front the report.rtnditte. HKS, however, gives prtuntv Idinitial request’ for Secretariat Revimss’, Due Proueua- Legal Action Peuding

tmprnper iteeseleses for Seenetoelal Erenpiet A practhioser dispntedo rrpssntRn s,5 en the revorudra of laser herctint cci

. . privileges bye hospital us the basis nitatAveqaastfurSreretsriaiRcvtesssts . duepnaontsweu denieddnriogeaasidcaed improper svtsun the report it professi onct review. The practitionerqnesniun tat nut peerlessly beer, dtupatcd furttser stated ilast n’mce Ite cc the hadby the s-object. before requesting initiated a legal suit ou against the hospitalSecreasial Rrctrw, a subteen most rest regarding the due process. the reportsnempeno resolve the discgreecieciwitle should benemoced ham the SPOIl oaththe reporship eutity and theto may dssputt tegut anti 00 isresoiveoo.the report according to the iustendnionsprovided outsit hs-000lkst015t oft Repurr 5 On letter’. The Secretary deleretised thatflit Data Butct0lbo documeot. the dispste ee quest scan onuide the scrpe

of devilts’. ‘floe Secretary additionallyifu suhjec submits as improper request uaied that ifu ralet ued ott erisitcst iofoe Socrelerial Resiew~ IheNPOR will euporash itchaugenu itteartissopteviouslycodfy the nobjrct that the edpon muss first reported. a second repen must hrhe disputed atd resolusioo nllcenpsed with submitted by be reportine entire Thisthe reportiog emity. new report could make connetinea, he

rent niea toil te act’tes, urban mid ofthepuiov report.

v-u Susnaint,oe ansi

SccensrnialReviens Osers’ioss’

r‘adiMeotsosno

I E_’meea,esnuousecctoan

Sucratasy OHSReslu-,tsOsputo

Dueninontutito

Seprehesttaat

N Pa 0 0 svb oakNEOn s,staatou

Lieetnaure Compleeinn’Trtgger Date

Enmplct A phannacy ntodecleotomittednoactoftlleted malpractice while intraitalog it the pltansacsnfn emil stare.The stodent had no liceonc at the time cithe alleged net, Ho’asver, nt the time thepavntent ares mode en the ntsdegt’s behalf,the student bud completed training nedeeceined a license. The peaetitieaerdisputed he report on the basin ttota

engr mast be licensed at the Lime ofthe alleged incident is order icr a report tobe made to the NPDB.

On eetnnet The Secretary directed thaethtreport be voided from the NPOO since iihat bees deteean’med that the tppetpaiatetrigger dote fur determining ifthepnaetitioocr is licensed is die date atnvtaiutr the reported incident ocesinrnd, netthe date on so hictt the parnsealt was glade.

Narntiotn Oeserlptitu.Innceoenne

Eeamplct A pteetioinaoerdinpated a reportoft lice stat, disciplinary action taken bya State banord ofmediaal ensmirteruotat’mgtho the ilartative regarding the act ororaisatanwnsuaotarcaeage. Thepeaetitionerreqactged thtr the dcaeripiioabe changed to reflect the (attics oftttgboned.

Ootentne’, ‘ha Secretary tee ironed thenartatinie tgaisst the rttditgi reported hrthe State board ted delccnoiard that thereport waatd he accurate if the aonaaltaagtaoge (torn the hosed’s (todiTlra wareaced, The Secretary directed the SPOD tootaaage the narrative. The dispute totatiensons reman’ed irons fine report

N‘area tire tnenrrtpeion’ LcgalSufficiency

‘line palpate ofthr taaoeatise descriptionsection ofthe erport is to describe the aaas.omissions, or reasons far the adioseeparted. Section 423(al(3)(B)oftheHea!oh Care QatnaPoty .dsastraeace Act 142U.S.C., Section t I 13l(aX3113)I requlosasactt”desceiplian ofthe acts orooaissioenar odaee eeatons ‘or the action.’ lhselegislative binary states than the narrative

dresnot necessarily teqaire taoesteoaive deaeetptioo ofotne acts tar

otiten reasons foe the artiooifhtaassn, for the etnet-ender. It does,

hosverer, eeqsire oatrteirntepeciraatitrtaeatable a ktowtedeaatslo ohson’er todetrrtoise etcantythe eieouosstaoees ofiheactiao or sttrretdee.”

A stenil’acant onto her of rcparts do totmeet these legal oeqaicemrots. Thefoilosn4og are esampies of tingoltyinadcqoauedesertpotouu fotandiadneitarratiso descdption scott na ofdi tptttedreports:

Example It “Dr. Xwaa found to esitibitimproper and tmprofeas’aottatcotdact”

Eaampte 2t “The ABC Hospital Hoardtook float aDios Ott Jattaty 2. 994,intstitatiog a mattdatorv concurringcotsottacon and moninaeisgreqairgmtatfoe a 6,mocth period, follow’use an appealby Dr. V.

F,snm pIe 3: ‘Sec attached letter,”

Outcamest Etc Sccretaoo- required theecpaeting eatities Ca coerect the eepotls toiocintde mere~O~lives, ‘lit: contents of ottactaeeattsare nit entered hate reports.

Nartsatirr Deseriptinu . attateadieg

Esumple: A practitioner diaptated ahaspitat’a repeal thatheeestgraissbiientderinvestipattao. ‘fite rarratite alatrdthat thete sseee no qneac’osn ofprofessional coarpetence or ooodaet hotthrt the 555cc that led Ia the iesendgatiooatdthreesieoatioo were probtennt’mthepractitioner’s bedside macerr.

Oatcomet TheSeeeetamsieandthat therepatl untold be ‘aided because thefreattriosentigaaiott as shassot in thenaegatise was toretated Ia peofessiaratcompetence or roodatco. The hospitalehaaged the eanratice ef the repantoirdicate that itt itrentiratiasuedeetoiaen ate nnntter ofp~t~soiettoIcampeteoce d ne toarrisdiannonis oftpatient io tIne eaaategoneyrasam. Thepracniliontor disputed this recited tepart.The Srcretaiv reelesead the cotnecoentreport andtheotppotlisgmateeiatssbsadtted by the hospitni ard t’ontnd thatthe corrected report showed a rcpotaat’te

It is uoctcarnshy the hospital submittedthe initial report so ith lanhnaaee in thetaatativenttan made the tenietatnon appearoorepenrtabta. Thin case aceves toemphasize the impoasanre ofprovidioeaccaeaaeaodctnmpteteitt’enontiao whettcampesittv the oaotmivesecei anolareport.

rrin’iteees.Resientnion and StrrroderWhite Under tnv,stlsatino

EsamptetA pnaoeitiooerdispotrd a erpertthor ho had resigned pet’si noes drriaa assi000stigationretarentt’te prafessisotlcempe once. The prorcitianer disputed therepor000 thehasicthothewasaagssmtnefaayiovesa’tgntias and did net bet’aoveonewas ongoing at the titne. Etc practitianeeatsa wired that hr did oat nasign ia orderto aseid nrecirw, but boetnse hit ertitacctwoaeapiriogaadhehadfouod anewjah.

Seerrtar~’n Raspooset The Secretaryrequested titan th eenticv tobo,iteotttetnnporaoeoos daettnsesttarionshotviogthat the entity had ondeetahettatinvest’ttatioe tithe physician. Sachdoctmetntatioontt’ght save ittetntdrdftndinen ofees’iewnrs or dieectises oliheeseeotivccoasoaittre or other pmfessianalravine bodt’esitt the hoapitat, ormioaitefrom a peefeusieenatrcriesceotity. 11wctttitv Santa usabte or tanwiltiog to provideany docometatation that an i ttsest’teatioowas occurring at the tinte the ptactitiaoerleft, St‘ore no eootempotauterusdoenmsetttation ofas sagoinginvestirationseas provident, the Secretary deternoisedthat the report nhntttd be voided,

The Secretary also stated that ttaegnraeuitlaoer nerd not he aware ufauOutgoing ins’csoinauion ar the linear therest gnat too to ntslee (or the eneity areport the resignation lathe NPDB,since nattIly ttscatigottotot startany forntat atiegalton lacingagainno the praettetnner. Tite reason thepractitioner gin’es for curing an ratio’B’hile under t’nvestigattnn in trretes’annen repartoltitits’ tithe rcsignatton.

Pr’in-iteges.Sonprnsioo and tioupitatNpotin aetnn

Etanuittet A practitioner disisntrd tiereponsofasuspea non ofetittiratpri’uieges. The peaetiriaree etatmed thatthe osgtivutiott for the actt’an oven apersonotiry conflict saith the ctaainnns ofhis departoseot, amotoen utteelated Inprofessional competence.

Outcome: The Seenetatr detemtinod thatthe dispote rococo noes antside the scopeofeevicsn, since tite mea’eatioo of theiaaspitat ortndivideslsinvotredisthrcase

inwed by the Seceetan’ nod mademl etttty to titan etfret ia the report. Thedt’spete notation was rotates-ed from thrreport.

5°rnfensslonat lcesimr.At iereattn’eEmptoyntene Termiunthio Procednre

ExanIp Ic: Apeactitioaer dispated a reportofthn eevocndon ofciiaicsi peiriteges.The haspitai has a system aipeafessianatrrviesvestabtinlaed andre ins lsa’tans’r anddetiseta health care aen’ices, The hotpitatalso has an “eespiaysttettt terminationprocedare.” The employmocetoon ‘matian

as med by the haspital Is enda praotininner’se mpioymeni se-i host taotithe professienat resins process. Thepractitiotter’a ptis’iteeessocre revaked bythe emptoniotent teonsloation ptoeess. bareaactt’Ott noes taken ttoouels theprofessions I reviunv penoest.

The practit’toner was gives no option ishans ito teentt’saoioo ss’oaid occur,

Oolrnmet Etc Seceetan’ directed titat therepert be voided from the M100 since theprofessional ren’iew precast had not beamfotiawed iii eetas’nnatitg dtt practitioner’speivitepes. The term’matiaa “as not apeotcssiotta I review action.

Some haspitatt tense its ted that iftiteyfallow professipas I revicw procedures toremove the practitioner’s peirileges, theymore theo fotioasemplovneentaeominaoieaprceedaeeo itt ranter to fire the pesctitiener.Hospitals have stated hut by fallsss’methe empiaytoottt temsinaniat procedt:rns,pmctitie cern’ peiv’tieees set 0 tatemotientlytrsttitate. Doe Itonpitti roqaired altpItysietassna ntaft’nc, waive their eiehta inthe professional rev’tetr process antcondition ofemptovoteot, Health tare000’ties toe reminded thtt in order lobereportable lathe NPDB, adverse actionsleast be lie result of profesnionat review.

Hesideoes Stuttus

Example: A licensed medical tenidetad’aputed a Medical hlalpracrioeRc1saiton the basis thatshe tom itt trottingan die time oftt:r tocidetit.

Onreomet Etc Sea.-oeloay detemaimd thatlie din pate requesowno eutaidr ito tcopoafres’iess cad made an coin’ to that effectin the report. liar paymeot is reportable ifthepoactittasee (ret nedlesn of residentslatnas) is named in beth nite claista udsettletttent arjodgemrnr and a pa)saentismade on his or her brinntf. The dispotenotattean nets removed item the report.

teesponsibiitty for Treatment

EnamptotApractitioaerMedical Malpractice Payment Reportbeoantse she sanv the pattern only anne sod‘sos nat responsible.

Outcome: Etc Secretary determined thatnito dispote eeqoest was outside the scopeofreviriratd mad can entrvta thatetTeetin tho report The ntn,theroinitaesnpatieaaniaoero by a practitioner or thelecel afresponsibititv is ioetermt to

roptmhe,aatt ‘5

Npiao rsa,oas,’L raarns, r Oiuassea

04 Sna050t,200t

rtarittraiunsss tatia rsseisst

reporting amodicnt matpoacsiee pasnacot Suspe union ‘ tnttetintte LengthThe d spate netatioa thus manved fromthe rrparn. Esampt cc Apoc Li darter dtspated a report

ofa snnnnan sttnpmtsn’on ofchnicalSeuttemoon , Subject Obagrees priniuiepesosnhe basis that the sorpesnioa

555 less thaa 20 days. The hospitalExtunittot /t practitioner ditpated a reported the asspeoaian afthcMedioat hlatpmctice Pa~mettt Report on practitioner’s otinirni privileges on theIto basis that he did oatraectaess’ialtniae 19th d ar of as indeftnine suspension.

neotemont Attendant to the sospcrsinnnsasaeeqsiretnerrnltar the pracliti ascrcsmptcte

Ontrnmet Etc Seccetars determined that a specific cosnse oftetion In pssruhistrithe dispute reqocstssas oflstdetttesoopc csatoationi. When tbatactionsvaaofrevienv since the paactitiaaer’s completed, ho hospital’s profossionata greement tnasententeoc it imtievaerc to rev’tear hvsdy cc instaled nine practitiaoer’etine repartnbii’its of tie poansoet. The clinical paiveteges, The prneoilitrerSecrrtamv tradeatnenney taihaorffeor in mmpleted the required actiett esthe ZOttttire report, and the dispale oo,talion watt day ofthr suspension mdctiniralroloabed frotn thercpaah. privileges wrreimstediatnl3’ rostored. The

tmlonsian of the peactiti aner’s etisicslSetutentene ‘ Snhjeet Otnmlsnrd (rosa privileges didart eseeasi’al days, boa theLannsait haspitat did tot eeqoesttitat die report be

raidrd Item dtr NPDB.Exatnptc: 5’ practitissnnr dispnteatMedical Moiptartice Pavnteet Report on Oulcononel ‘fine Secreta directed thethe basis thotsitrwnu diamlased facto the NI°D0 a void liar report since dte donoriostawnuit by sommusyjadgatent hrl’ore thu 0 rdte saspennion ofiate praesitiarer’sscnIcmenr. The eider erstrfeg ssmmany clinical privileges di dora exceed 311 days.jsdgosenl presided that the proeti 000cr bedismissed from die iasssok na having no When atomnt aly suspension Isliability, and that the piaitaill’tmtie no iodrfiut Ce in rn gntu, it ahnotd user herecovotyagaino the practitioner. reported a until it tea beau in cRocI far

sore titan 3n dart.Oateomet line Setrctarvdirected theNPDH t a raid the topo It since sac laittt Suspension’ St molarsesisted apa’mst the practitioner and nopavnseost s’ as otade on his or bar behalf Esamplet Awpot’s’aaronde to itoAithoogh the instnanrrrampasy may NPDB regardt’agasu mmaty staspensisshare named the peactinioter lathe reioaoo based Os a preetitt’otter’s profesnianator sentietsonl, any paylrcnt made would competence, sehieh did not last m are thaocat be to beitslfafdtiapractitiarer due Ia 50 days. ‘fine hospital tank nn meponlabtethe sonsanars jndgrneoi order, action foitawiog the sommany saspensiaa.

The practitioner disposed the reparl sincethe lentgth afaite uospensiao 55nt5 lean thas30 days. Tho proc tirianter resigned a yeartalera bite suit tsnder strati gation ny ihe

ran seomsbnsuwlOtptonaha Not

NODe Countess

hospital brIbe same Eye of prathssioaulcoospelencrassue. The hospital subnaitnrd• report oftire practitioner’s resignationwhile wader investigation. Theproctitictrrr disputed this report on thegrounds ahoathe song issue had pans icaslyheels repented to the NODS.

Outcome, nan Secretary’ directed theNPDB to sold the lInt report since thesuspenaisndidnoiesreed3odays, TheSecretary determined the second nepon tobe eoneert as submised since theresigantien ofthr practitioner wansnbn’ieed svhite tinder iuvestigrstioc foeissues related to professional competence.

The peacstintterwas eonoctdsatdtereason for the eeponn ss’as the unmethosvescr, retwienabitity hinges cot opoa thenature sf the probtent on ucidisci. hot onthe rircumnloneeu wider sstictttttreeportsoas made (the stspeusiuu versus thercuignaties white under investigation).

Questions wad Answers

I. lam theeseconurofntssissife’sestate. I recoised nolifleotlun nit.report ahoot her in tile NPDB. CanI dispute lie report?

Yes. Ta dispute a nepons on yourwiles behalf, you maul providedoeuntentaaioa that yort have beenappointed the esecotoratr legalrcpeeseuiative ofher eslalc,Acceptable documentation coo bet.photocopy olher will er other legoldocooaentotiousl’ewing yea as’ hectceeoauerteeal eepeesealutise.

2. NV]aonnau Weed altonnpn, In resolve adisagreement nib a reportingeotlty. must the dispnne beresutretisummit a ecrunin limo irene?

No. A subject giant inlarm thereporting ectiny. is welting, nfthedisaeeeenseetssith the recant and thebasis fnr thai disagreement. hot there isatorequirem tnt that thedinpast tunabe eesettved ssithin a ceriuiri omnani ci

3. Ifn subject wirheson dirpulearepore, does Iheunbjeen have Cusnbinttasic. omens ut the lime ordispute?

Na. The subject may provide astulesnean with the iniaioliun ofdispsoe,but is sot required to do so. .4 SobjeetStatement may be submitted at oatstime.

4. ?ulnstaou hjeel initialeadinpuleilorder In add a nlateunenl toreport?

No, ‘lhosuhjecloforepoetmayaddastatement too repoen independently ofthe diupone process.

5. Iruhe Secretary’ nulrraodispule to bebeyond tltesoopt ofrertew andplaces unnlanion In Ihis edleen in nbcNI°DIl, eon the subject alan add aslatlooienl?

Yes. Suhjecns are noiifrednlthisoption by’ the Secretary. .4 subjectSlatennetrt odded no the report afterdispute resolution teplacei aoavpeierSabject Sluteinenl.

Ctaqse, norma

completed form boo been submitted, theNPDB’lltPDB ‘sill establish etecteoniceemmonientirss with theeatit?a hank.This process takes approxincately sansseelau. lire entire wilt reoeiseoeriraeaniosby mail that the OFT areoctt has been netspsueeesufullr. Outings should verify altoiefcrmaaioa foe ucoanucy and, if theee areany eenonn, made their eOeeectioos no Ihodocunnoun. aims and dale il, end return tothe NPDB-HIPDB. lfiheial’etnnauion iscotreen, the enaaiiy slsootd retain il forfuture eefertnce.

Once an entity eeoeiveu verification, itmay begiu a pay for query fees uniroOFT. Query vhaeoen saiti be dndaesedautnn,aaicauty from ths entity’s desiginatedErr neconon, Iiolitrethepeecesuolpaying by ceedit card, rho aser dam netneed laeaiter EFT eco,oaaninfuninationwhen rreatineaqueey,

Entities rise neupoassible furensuning thatadequate ‘usda am presait in thcir accountat the time queries are subeaiued forprocessing to avoid icteeenptian nedponennialnesrsinoaliunofsersices with nbcData Baths. Iran entity’s OFTioforuoarian chances, a ho touts’ isresponsible for nonunion he Data Bathsby subraaitlicgaeew Eleroenanrlr FoodsTeon.nftt-c4urlmrL’ooioa font.

Eligible entities ma’ elect to bane outsideorganizations query’ cnd.oe eepon to theData Bnahs nfl their brhutf. Such nonrgami2ariatcisrefeened to as theauthorized agent (see Chapner 0. Qotedea,for moot iafaennstioa about authorizedaceRb). line eutily may choose tothe query churge sstessed to oidaer the

Ce theeetiny’s credit card or OFTnceonmt. Agents thm pina no charge qccnvfee, to their EF’laecoann mnsteatnpteuuas Eleeis’osfe Fu,ntt Traoasjis’

.aaaalnarorauioss lost before OFf paymentsbe processed. I frito etality iatcods for

the fees fee queeins submitted by the agentto be assessed noeithrr the aeoet’u or altoetrtutv’s OF]’ aeeasnu, the rout)’ mostiadicate thispeeleeencensthedutlaertzeadAgent Desigonnaian feeau. mailable atsnncnjyla-ltipelb.erast.

Eutinies and egeens may stew sleetycharges on the Billing History screenwithin the IQRS. ‘This semen pmvi dos themost eueeeal infoersani an mailable Tsr

and agetits to better reconcilequervrhmge amounts as they appear amtheir EFT or media card stanements. Foreach query nalamiasion, the Billing Hiseotyscreen provides the fallossisgitafonaados:the Data Back Coolant Number IDCN)anstened so the query submission, lhe Datal]nstris) qaeeied, die number ef qseniesprocessed and oltaemd compared no tiretotal somber ofqaccies is that subtnissi.sso,nlte dale the credit card oe EFI’ accountstan chanced, thnareomt charged, thu typeafpaynnonauned, she last forr digits ofthoaccount nramober, atid tie pnocesnitngotatasoftlte bill,

Entities atsa eeseivea Charge Receipt withquoty eespacnos. This document,

along mints the infnennanion en thn BilduotgHtetaoty’ screen, stay ha used hr eutinies foraccounting putpnten. The Charge Receiptptosidesalisto f the queried sabjecus. theseneclaresu Its, and the assnciated queryfeea,

As OFT Chaege Recuiptalso contaittafoltosving infotaeaairn:

Dana Bank tdcutt’ftgatioo Number(DBtD)Entity Name

• Entity oNddresu• Paymrct Method

niPEt C’rsuiolw,a

sotaesit.mttOlt I’ll

tartan ttdaehnd, runpcuinrnnn

Qtuerv Fcea Sonf.Qatrni Fecu

aISle Qoers Fees .4 peuctittoner may subonit a sell”qaety at‘ anytime. Self’queryreqsesvs fur

Focs ace olsatued foe all qsonieu .sobtniaed iudivi duals are nato~nitatty srsn no bathno thtNPOB. Theqcery fee isbasedoa theNPOB attdthrtilPliB. strdsotf’theeosa nlpasteestiageeqaeutsattdpeo. quenicraansesssessedalrefaoeae]sDaruvidiog iafeaeslionc no digit, to entities. Oath. Alt oelf’queries must be submittedThe fee is len’ted no a per’naane bauis. thenagh die NPDB’HIPDtawcb uite athvhts madtipto’namt (i.e.. batch) qoeries trnasa’.tsamth_hayolb.com. After ramptetitreare submiaed, the numinuenfinames in the the eo.titie application, a uetf’qttenierquery is multiplied hyshe p5.-c-name fee. If ritonid print the formatted copy, sigrsit(inasetigib It entity has registered for both mk)usahe presence ufa notary 1aublrc, andthe NPDB nod the HtPDB md has mailnhenoeurieed fonts to the NPDB’seloroted the splint to qoety- both Data KIPD Bscnheaddeessnuted Os the fans.Backs (‘in Secninn D ufatre £orh’sd?egistmaion font), each qatey is Melitoda of Vayttsemutpnoe eused sea ittsn built Data Baetazs rodassessed the eunreai faa foreaeh Data tire NPDB acrepas payment by credit cardBands. (VISA, iliasuencard, ar Dircoree) or pro’

authorized Etectaonie Faaads Teasufeelire tort ufaubori dogs quay to the NPDB (OFT). Alt uelb’qneay lees ttntt be paidiscuasidered m agreratent to pay the by creditraed. Peenaonlrhectis,monoyassociated fee. Aferiua,suetued sshetn a orders, oe rush an net acme pied.query is,

Entilim clrostsic ceo pay by atedin card do• Peocessed by ho NEOn, regardless of eel have to make advasee anantgemeots

whether them is irtfcnmatien on file with the NPDB. The asers)toulsl corer theregarding asabjeet. credit card number aedespiranisn date cr5

the appropriate IQRS screen whenn Rejected hythe NInDB hs.’caase it as cmaning 5 query. twoterCrsdit mmd

itnpoopertyearnp~~ed or ache inalaee,asli oomast be entered eath time areqoineri inbomaatron. query fate in crested: the IQRS dons net

rureennt ystore thin ‘mlnntaation.)Event ssireu at entity donLunatesanatahaciaed aeottt to query ant’or report oa Eotinieschooniog to pay by Err crustbelnatfofdre ectiny~ the entity is uttimanety sabmir an Eteeoi’oere Buena Teoaajerresponsible fur payment. Cunttuonuut ,slarhorizo,lota fonts before OFT paysnetatsaenangemeets with auttnenized ugeats cans he processed. The frun es available atshould include procedures far payment of snmaonpolb’hipndb.rom. usainans mostqitety fees, pros ide their Data Bunk ldeauifrcsnioa

. Number (DEID). bath ronthre code,Query’ fees arc subject to cttange. The acc000a comber, the type efacrountScercmryoftiHS announces oey’ cltaopes (checking cc savings), attach avoidedin the Federal Regosuer. Query feet art blank cheek In the farm, and sign the loutbmed on the date elreceiptst the NPDB. ‘ is tile to establish an OF]’. Dnee the

saflsmssnne’t u.n 0’2 Oouieeshcs lost

crue,Grnsn rrmr,r,asNeat sscukss•

• Account Number• Transaction Date Dole Queried,• Trousretier Number• CurreurDase• NsanubrrufSabjrsssingurev• Number of Subjects Processed Wills

Charge• Number nfSsbjeets Previously

Processed• Nsmber of Subjects Net Processed• Fee Per Subject• Tutu’ Charge

A Credit Coed Charre Receipt ersstairs risefollowing inl’omvnuiou.

Data Bank ldestifscrtion Number(DBID)

• Eutitv Nome• Entire Address• Pa(isuesutssedsod• AcrouutNaasber• Espisatiea Date• Transaction Date (Date Queried)• Teaarsacliau Number

Dole Charged• NsusbeysfSubjectsiu Qua’s’• Number afeubjects Processed With

Charge• NumherofSobjeets Previously

ProcessedNnesbernfsuhjesss Not Processed

• Fee Per Sabject• l’otal Charge

The Number ofSehjrctu Not Processedl’scld rclhrs en asv query rime has a‘Pending” ssatus.A status of”Pendisrg” is

assigned to usy quesy hot requiresadditional research boforu it ens becomplelcd. Ceedil curds are billed onlysslscs the stauss forase bjece is indicatedas”Cosupleae.” tsr Chsrge Receiptisscls den the procens’mg assd leeinformation fur all subject names

processed svitltie a 45CQ’, regardless ofthedute that each per’rnuse fee sssas cisarned.

Account Dinercia uncles

1f3’osr BET oecouet infoe,sssios (e.g.,routing sousber. hassl.accrsutiet’snnutiou) elseasges, you mast sahmil augsv Ekeirasese Fsuetu Prowler4ssihse&osisa fannns that ssesstaini the ussuinforea mien. Yosmusteusssrestrasvouraccount informarias is kept cuerent toovoid isssemsplios ofNPflB sewices.

The NPDB’HIPDB eutlecu euusosdisagquery fee balences. The NPDB.FIIPDBssill request the uslisy Is complete usa,treorstr Balance Trasqfec Req’s’al foms toasthorize seotemzrs afro eatstaudisghttaasce. ‘flit l’rrm is available assrs,sn-sqeaeth)spdieum There is no timelinassstion asrociasadsuith rise coltecsiouorsnonputd qseryc hoage

Recrssci lotion uf credit turd statementssense be drug threaoh the bank Wet isssedtltesseedit card. Ifous believe that yourcreutitcard oeyoar EFraccoust shestdbecredited or debited, eortaet theNPDH-allPDu Cassomet Service Craterfor assistance. The NPDB ssillthe dtscrepaecvsssd prnvideyoawith aresolutios or arequesi far terseis

The NPDB issues debits when:

• .4 credit is mistakenly applied toutattnssL

• Aserieietalthntgeisort paid

Requesls for credits slssstd he madewithin a 65’doe periud. If yon suspect thatyour bill is isearrecs, or ifyru seed nsreelarustessias ul,essu a eronsaculan on yauebill, ptensg susise usas soon as possible.We msas hear from vo~a so loser thus 60days ullee ycsssbmsrted the qaasy 055

sshiek itse arise or problem appeared. Vunmay call us ot t’105’767..s1732 to reportthe error, bsa duiag so will not preserveyour rights. Year teaer trust provide ritefotlossiug isfsrmatirra:

Ynsar anne and credit card or OF)’occessss slumber

O ‘Else dollar onsouss of ks sospeesed

• A descripeinus of the error ottdesplasasier ul’sslsa yes believe hereis as enloy

• Ynsseentitysandioraeest ‘s DataBath Ideesi fseation Nnmher (DRID)

• Yesytetephnaeuunsbeo

Vussrsiessture

A copy nf’our hilt

use NPDB has lbs right so collect allonistandiug balances withent priarapproval from the customer. Thiscoliectins natherity does not etcpiee.

0’4

Ifo’osr orgosica lieu in due a credit, becredit mast ho eeqnesled isa ssritiug withinthe time peeled net fes~a by the NPDB’PIIPDB. 4ftevthispeeind. norefurdswillbe wnmntsted, Ia tire esest uf amresceoracquisition efasothee entity. she remsrgoaizuticssis respnssihte for paystencofany osassandivu debt of the priororganization.

Bankntpley

Eulities am responsible fee rrtifyisg theNPDB sfbanknspsey in sveitiua oninclude the lot lossiog isfanrsalies’.

• DBID

Daily Manse

• (stacy Address

• Type of Saehosps,ay .Cl,apsgr 7,Chapter 9, Chapter II, erSsanet.iqssidatinn

lfyour organization is usdrrgaieghsnkauptey, rite euLstasndine batsece ss stillcotlectable sstil final rrs-etssuios elitebankmptey, Poituam to sonise paysnetls noshe Data Duals Is) eats result is yourerraniealion boise leemitsoted frost, accessen she Data nash(s).

Qoearioon and Answers

I. Huss dues an entity requtola credit‘roust lie cr015?

Site entis,. may cuslueo acredit bysnhaaittice tm necessary detaits usedsupportive dos’unsea muon (e.g.. thequeny Data Bank Coseral Number,qucsy bsrels essnher ifpart ofoseutsiple’naasr submissieo. aid hiltissestateseent)to the Nt5DIO in sstilisg.

Credits nud Debits

The NPDB issues credits ushma

O Afeeisincurrecttyas.s-rspgd.

lire NPDI5 to esese data procetsise

Segasshusasnt e.g

srrsa siusaesssl. rtewsea rues

2. Dues nttei5iPDstrcconcilerretttt 5. Mv kuspteul is in Chapeer 01cord ntbtolaes? buntaompley. Can it estllene to

qnuns nOse NPDB?fit e NPDB ea eisa anus a qa entiansnegarding credit card arerass Yes. Your uegarizatios salt bestatetartis sent to you by the bask charged for all qeeries submitted aftersisatissued vrsreredil card, stercant the NPD tsresaeivesnotice nl’ttte lItisgshe NPD Baddressnrinvesu’gate ofthe Pesitioss for Baaslansptey.ussstlsotiaed cisoeges. plesse contact Deganiealioeu tsar save or ubtigoliunthe bankthai issuaed theerodia cord for to qssenythe NPDB (i.e., hospirats)assistoure. muss stilt meeeulserrqeta~-itg

oblieasias.s.

3. My lsonpi tnt isis Citupeer?bankrupbe’. Con It enstinne to 6. Ms hospital has bren liquidated bypoesy the NPDB? the Slate. Can ir eonltnur I. qaeuy

Itte ressohl?lfyonr hospital hat onoaieg ha,issrssosnd is funeti oniag nsa hospital sstsile lfsoue hespisal has osgoing kssiartscescludisg ins tiquidation, eves under and Is ‘sects oniss 050 hospital ssbite5 deblnris’possesss’et, lissusi esssetadicg its liquidatirss. it mastcossinaeto qssesy use NPDB. Ifit is coetinae to quety thcNpDB, Decois tiqsidatiots sotety freelse prepare of the liqaidagist process tins cnsetssdedsate of assets tsd thers. is. ea esgoire oryeur oegosizatien has Sn oneeingbtaieess 050 tarspitat, there is so business ass houpisa), thete is noreasnu fee yoor orgasie.atisn a qerry reman for your sreaniaationt a queryand yore DBIO oil be deactivated. otdvosr W3ID ‘sill be deaciiselrd.Yesrosgnaizotiea is respomibte for Year ssgsaiaation is responsible forsulit’yingtlse NI5DI) ofits stalus. If ealifytte tlse NPDIS sritsseatss. IfOre Isospitat comes sader new the Isospitat comes ned er urnsrssaseestsip, th eness ossasermssst sssssersbip. doe sr.v oavner masseeg’sster wists due NPDB and is eegi.sterssitls tttr NPDB tetd isnsjsousikte foe futfsltirg its reporting respcssnsihle for fsltiltite irs repoeaagaud qaeevistg sshtigatiest, and qteeyisg obtigatioss.

4.3!’ hospital a in Chapter 9bsnkru pin’. Can iuqosen~’tlteN I°DB?

Yes. ‘bess Sos pilat ss,lI be chargedfar alt queries ushmitted after theNPDn receives notice efthn fiting elUse Pesitiess for Baulanspucy.Ormizatisrs hal base an obligationto query the N1~DB (‘s.c., tsuspisals)ttustsisll assess their queeyssuubligatioss.

soeeeoo,2505

vol tisidetmek Doria, totr.fain,aertewou

NPDB-fflPDB ‘Vein 51ccAss iota ewe

Jim Nulional Practitioner Data BarkOlealiheare Inteenily and l’naleclian DataBank (NPDB-HIPDB) sceb sine, located ats-rnvanpdb-halxth cml, allows 3:01110mteractsi,i’lb the NPDB’HIPDB moaneasily and quickly. B’ using onnrpersonal computer rod the Internet youcan inslanlls access.

a rise talegrated Q aerying andRepotairtu Service (IQRSI niltese Datalank querying and neporlisg occurs.The IQRS cotttrins anvctsl Securityfeatures Ia pttvent uttanthoniced accent

ensure the cnn Itdeotiutiiy riittfoematian.

The St’iJ-Qsca~’ Opuiatct screen, whorevon tasay compielneas individual ororganizulinn sell’-qnctv applicadon tadthen print a formatted copy furronacizaliatu before mailing itteNPDB-HIPDH. You tear also Simsthe slatus ofa self’ttaeny that waspreviously taanta-,nitted to thrOatsBatukis).

• The NPDB and tltFDB~

• Face Sheen and Furtns, including theOnothi Regdrnroeitot lone. Act0torieeelAgentt Regdsoreanion loss. Atd0torieeal4gets Deau~ea0ion foss. andeoecet-ottt’c Ftoedu 7}tattafea’.ltehontoiiot, Ion,,.

A iistofattthcnized agents.

• TheNPDBuudHlI~DBgos’eniingttatates and regstutionn.

The NPDB tttd llPDB iniceacciveleaittiag Peograntu.

• lnutesectiatts and eeqaieetneata furqnetyiag sad nepottiug. icciadingsubject sell’-qseeies.

• Artiwees In freqaendv asknd qsestiotrs(FAQ).

• Criteria for cattitveligibiliiy.

a lnfemnaaion en the d’tspete gleans.

•Attarehire oINPDB-HIPDBnessaletler, and tither publications.

TheNl’DB.HIPDB nash nile includesinfemsalion on boss to contact the DataBanks. Please visit lie weh site toisntantly ruccat infoematiott and findanswers to your qnestiouu.

NPDD.HH’DB Customer ServiceCenter

For udditienal assiataaee. contact iheNPDB’FIIFDB Customer Sen-ice Centerby e-mail at apdMtspdhgrrm.reet, or byphone at 1400.767.6732 ODDiss-502-Slnal.

tnl’staaata’ou specialists an as’ailehln Isspeak with yea sseekdayt freim a:30 a-usia 6:10 p-rn. (5:3) pm. en FeidayslEa,lem lime. The NPDB.HIPDBCastemer Service Crater in closed on allFedent Itolidays.

Data Bank Addrroses

Requcstt foe general iafotnual,en alto’s theData Banks and eeqaesru foe Dinpate andSecretarial Res-icismalen’atsnhoatd~ndjrea,edtu:

National l’tacti liuaee Data DnrkFoealthcaee enlagnity and Pnelevtintt DataBankP.O. Box 0832Chanelty, VA 20153-0132

Osurmight mail delivery nddress:

Nslinaat Pnactitieuee Data SankHeal thcane ltstegniry’ and Protection DataBank4094 bdtjesttc ~nePMD’332Fainfas, VA 12533

Phnsteacmbem’.

NPDB-HIPDB Cntstnituter Secs’iee Center;1400.767,6732Outside the U.S: l-7n3-S1a2-93a0Fax: l’703.502—l222‘lID I -ln?.e52-0395

Requests lee aegrega tetunst he addaeasrd to:

Diritian elQaality AssttanceReneanolt and Dinpntes Snatch7519 Staedislt PlaceSeite 300Recksille, MD 20157

‘Theremaykeachareelnesomedntaen qr e at a

luoler]arctaliott oINPDB Statutesone] RelilIlatiuns

The Divisina of Qaalily Anrtaace.Smear of Health Pcsl’enuioss. HealthRenoarcesand Senvicea A do,ittislmlinn.l)epatlattrutt of Health and HussnaServices, is the Gosernnseat agencyresponsible fee administering the NPDBattd Ice inteepnerine NPDB requirementsMaltena that deal tpecifleolly ivith thelegal inteeptelatioa clatatuloly aa’,dregulatnoy aadtonily, sttcnld he dinceted ter

Asacciute Ditector far PolicyD inision niQoatiry AsaurunenItalics mmml,2519 Slmdisl, PlaceSnile 500Itocksille, MD 21657

Tine Pn’vacv Act and the 061mB

The Pth’eey.lce (5 USC (552a)pretectsIso ennlecla of Pedenelsvslnmsofeecords

on individeals. like hone in Ihe NPDBlnn,n disciesane wilha,,t the ind’,vidsnt’sconsent, snieso die disclosure is for arestine use uf the s~slem of necerda aspahl’nhed aneltallyiutkeFodoesetRegister, line published routine eat nfNPDB infnrtmlinn, ,vkieh arc based onhe Issss and the negaletiem ,attdeesvhiels

tIme NPDB operatm, does lou ncladedisciesure le the general public.

‘Voice to the address lu the IntenprntalienafNPD0 Stalulo and Regul tuniotuu section.chow, formnnein lunmalian.

General inl’ortertion uS Ihe DabBeaks.

soosnebw209l

5000 tancaat Dtne II tatec~~~5c~,

The Freedom oflnformalloa Act Federal Etnployer ldenlifteaiinnand lIce NPDB Number

The NPDB. as an agency sI the United lire Federal Employer ldetltiltealioclSuits, is required le eeiense records Ia the Nnaakce (VEIN) is ascii by payitg clii lie-npublic with certain escepriess under ilte for billing purpouesasasendsnpenvusiona nltheFes’etgatn nftsjntanonisn id entif;eeti on number. The sendse name,.‘iea(FOIA), S USC 3552. Theism rcidmss,aed rEIN lee the Nl’DBaneascrnatitmg lire NPDB, he Ileia0th Care InSunvs’.Qtaa0io’Impmornac.nl Art nf1956. asamended, Title IV ofp.t, 95,660, - IIRSA, Depanmenl ofHeulth and Humanpms ides far lisailesl access to NPDBinfeeatauien by ernie’ a alit l,oeized 759 Standish Placeindividuals utid enlilits sttd, undee lime Sitite SuBpnovinionanflhereioary,drn, 5 USC Rocksilie, MD 211570552a, protects peaetili oser infocmationfrom asnaltelanneed access. TI ‘elite’tied VEIN: 52-012-1661access pnosinina efthe Ifeattlt CorefIuaths’!m,etonwmeneAa’enfd9so, an Stale Medical and Denial Soai’daaanmtded, nisy street the dine Inoseereqrtirennenln ofFOlA. The Health Addnesses acid pltntentumhers farSiaieResnanees- aad Services Adm ‘listration of Medical and Denial loan] sane lined inthe Department of Health and Humait alptiabenical anise by Stale. BaconSensiecs processes P014 ecqnesla. Inc addresses thacane dilienent than mailingiulnouatistt about die lOlA as tcteluiesia addreasesam Ii sled iat’lalies, ThisIhnNPDB, please direel yoarauqsinylo: infetnnaa lion issuemacas ofthe pablicatism

date nithia Guidohsatk.HRSA Freedom of Information OfficerHealth Rcaouncesaad ServicesAdnaieisuutioaISIS Standislt PlaceSuite 300Rsckviltr, MD 2naa7(351) 443 ‘2 865

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APPENDIX A: Gloscary

‘limit gloaaan- contains terms thai retnte In tile t’iatioital l5rlrtitiener Data Bank C<PDB), andtltt delisilians apply saiy to their ucagr ltl caajuatctian Osith the 1’?DS and ins pelicirs andp ra a ed a so s -

udcarcu action — (I) all actielnlnloon again ala practiniettrr’s clinical privileges orlegaligalanalTmembensliip ion healiheare entity. se(2)alicamssaredircipliaany action.

Advrrna .~giina Codas — a list afadrerse acIa’aals and nhc ardes used to Mcldf~’ iltros “sheacabmilling reposes It’ he Mann.

.‘silrene Aclian Reparn (AAt4)— the format saneal by health cart eclitina and SlainLigenning Boards Is sepoll an ads-else uctilsan soLon against a phys3~~~ drnlist, or amerscald’ rate punanilirner,

ad,-erselr attach — reduces, restricts, saspeeds, rerolmns, or denies clinical pris ileges orcaecntbershipinaheallh rare cathy.

aulborized agent— an individllai OP negtoieaticn dIM an rhigiblrectimo designates no qletythe NPDB on its Inehalt Inmost eases. anaotiioriaed ageintisnnialdcpondgslnraninnrnorloliar reqsesling corny (Inc instance. a caaanls’ medical sold)’ or annie lanspital assecialinn)used fergeutralized rredeutialitcg. Anauttnonieadageanr cannon qanty nice NPDB asithoutdesiguaiioa Sore us eligible ratio’s,

uulhoeirced snbmitlIgr— as isdisidaal empowered by an eligible rstitr to Submit reports orqlleniesao lharNPDB. The sutitoricrd ntabmistrrrernif,es the lrgitimatv efiolontnation in aqilervssreeparnsabmitnedrollne NPDS. In stosl cases, the aathorired nibmitngr is assemployee oilIng rilgible eerily (such as an Adlnilissalororatedical Stall Director).

bunrd ornuediral eaauni,,en — S bodyornabdirinioa 0155db body thaI is drstgliated by aSlain far licensing, lnrnitaring, and disciplining pltyaigiann or delalilus. This learn includesboards ofoltepatinic or osleopathic rnaatainera, I cnnlpoiiiu board. a slibdisanion. oranequivalent body an drictaloined by the Slain.

clInical privileges —peiuitegns. membership antlmeniediral stall; and othergisciamstaatgesliarlading pa elmeanbershipn)inuhicb a ph5sicinsi. denIed, or alhor licensed sculls carepractitioner is permitted no furnish toadiral rare by a tientih rare cliii’s.

Correction — schacge isteuded is sage node a report in cite NPDI3,

Data Bunk tden,ir.earlon Funilarr(DBID) — a eaiqsr, IS-digit, idclltif,cahioaautnsberassigned is eligible realities and naihotized agents ‘shea they register as itt the NPDB.Entities and sgml, aerd this nmatber do qsgcv and report Is thr MactB rning she IQRS. The01310 ecusobe incloded on all cetcespandence no the NPDB.

ladrsut sao,nopnaa naIl

Saresaiaa A5luisc~ t-T050ssdssack

deallsi — a &gier ofdgsitat sarger,s, a doclorrfdeelal medicine, orcnreqatsulrlslso tots ismanIc astitorized In praclire dn,anisirs- by Slots, or sr,ho, ilsoan natisortay, holds himaelfor

hennelfaul to be no nnthorized

On partmrn[ af ltcsllh and ltua.nsn Sen-ices (HiTS)— the Gasemmrrl agency reapeolsibieferadltinislraaials CIte NPDH.

ilinpulo— a icsoaI, wrinenobjec lion afthe uecmmay ofu open or the Fun that aspestIrlecr001 anus rrpgngd is cisc NPDB. Disputes may be made tnly by liar Babied ofa nepoot.

Data lIaaL Cmalrol Nuanber (DCN) —the idgalirlcatiol camber assigned by the NPDB110115 toned 0 idelclify each query and report. Eligible estilien ,ose the Dcl, wtaai nubiniOinga CentOclioll ecu Voids Ihe NPDB.

draft—n report hat in lemporarilynnoared ,aillaaui beingsab,niined Is dsp Nt’DB-IIIPDB forprocessing. Reporlersmsna creole drafts ‘ssfacy type ofrepennulsd slam them icr l’ioscemineral fnr up Ia 30 days, Dugfl reports am lot rnqli red to ltaae all mandalol)’ dataelameras completed arid arrootconsideand valid subminsious lathe NPDB’IttPDB.

One Enfareemcun Ad.nttltisenalion (ViA)— the Gos-mrnmeatagragy that regisierapracltliatrns ‘dispense cessolled suhslascs,s mad assiens pmalatialaern Federal tIBiA10-ashen.

Electronic Fnndu Tran,ror lEFT) — a method or eledtroate pa,nneast rae NPDB queries.Eet,lies mss authctire heir bsnta, a ditmcdy debit their aerasals itt order to pay icr queriespuuressed by do 015DB. To use the Etecleenir Funds Teannferpsytiarnt medlod. dIlliesmtlsn provide elIte NPDIO the account number, routing codr. nod toTe afaccese,E (cheekineorsas-fraga) brIbe bank-aceosoat frolans’hirh, lee payssacul is asthoniogd.

eligible coOlly— am easily thst isettllled a q’aeay’ and-’orrepcai to lilt NPDB saderiheisravisions ofTiale IV ofPubtir Las’s 99-050, as speeiriod in 45 CIOR Pani (0. Elinibteetiimienmnnl certify theireligibility to the MactB in orderta querc mA’nrrepolt

Etitily Prlmars- Futelion Codes — lwa-digicoode nlast bonn describes the prinnaiyfrartirntyaareauisy terl’otntt. The code is aised on the Eatrrer Regisoasal(rai mm.

farina’ peer errienr prorrss — lice rasodarn afpmfessarllalretaewae,jvIniratltroaglsbanally adrpted ‘snilees procedures that provide frr ndrqaalo Inolice and en apportuniny forI inratinsa.

Freedom ofinfunnallon Act (803,4) — tile Ian’s- that procidesp,Iblic access to FederalGergnnnrnlal records. See the b,forcna lien Source, chapter ofiltin Gaidebook.

booth Cure Q000ioa Ialnprtsa-a’oarlsiAra a! 1086. as amended — Title IV afpcbhic Usc99-600m legiatalian ittestded to innprcserthr quality oianedieat care try earoaausgiog haspitals,Slain Licensing Boards, and other bruith g~e coIls ies, iueluditg prafrnnie,,aI sastielits. In

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identify and discipline those ssha engage in arprofessienal behavior and to eestoiel theabtittv rl’ineampelenL pracoilionoes to mm-c from Slate to State sultan disclosure ordiscovers- efthe pmsl,tianers’ previous damaging or iccompeleon perlhrnnancr.

health CO FO entity — (tOo iaaapital: CJ as coldly that prasidos health care sen’iees andfallow’s a formal peer review process ‘er he patposr seffartherino qoality health care; or Illa professiarsl societe or100,mnittce oragcttt thereat. including those so the national, Slate,or local level, afplnytieianu, denlises,orelherheatth cane praciitirrrers, that follows a foreralpeer review process too the purpose of furthering qaalily health care.

health care praclinionet- — at iudisidaal other than a pltrsieinot ortleatisr (I) who islIcensed or otherwise attrttoriaed by a Slate to pravi do hralth late services, or (2) ‘vIsa.sviahoottinate sathority, holduhimself erltene I foatto ~‘ant horizedro provide health care

nsttital las described in Section 1061(el(i) and (7) rfthr Saesal ,l’ecue!ry,oegg — ratisantatittiot priman’Iv engaged in providing, by or antler the supervision ofphrsiciaas, toinpattosts (II diagao,stio servires ‘ad Ilterspearic seniors far medical diagnosis. tttatnsrnt.and role ofiriored. disabled, oroick P0551s51; on?) nehrhilitaiior servicesrel,ahiliradot ofiajwod, disabled, et sick persotto. and, ifnnqrrired by Slate or meal lssv. isloomed or is apprsased by the lganrn 01’ the State or locato’retgontible for licensing

ltnspitals as ~~cling tite standards eslshlished far srsrh liceosdotsa.

CI) Transfer Prtagntm (ITI’) — a pnogtslm that commits Itinerface Carla’ol Doctesient(lCD) report and qtlery flies to nod from the NPDR-HIPDB. Tlaisuplionisasod by entitiesthat do ott Inave access to dte 1Q55, or prefer Ia g0000ate toronto and perits ntsing customsafisent

Initiot Retort — the orieiral recard urn toedical tautpm~~re payment or adverse actionsabmined b’ a reponiatg entity. .40 eligible entity references nan Initial Report (aliag theDO~) “hen sobntinisg a correction, Void, or Re’ isioa to e’ction.

Integrated Qnen-ing and Rrportingservlce (lOSS)— anelrccreaie. Internet-baseds’sstem farqaeryiar and repersine to the NODS nod the lolDD.

tnterlaeo Control Dnenennrinl lICO) — a file format for the NPDII-HI0DB that represennaall compoltenlo afreporns nod qaerista. Ortities who do tee Itave access Ia the lnteenrt saOylip their qaesies and reports in lCD fanmar.

It’rettsn~ disciplina t~’ action — It) rrcecarieo. sssprrsian, restriction, or acceptance ofsserettder era It’e~nset and (2)erasare. repoimnod. orprobsdtsnofa iiee’tsed phyricirn endertist bared on peofeusional eompetearr or profess’tonal condaet

medicat tssolpracliee payer — nat nutty rica t makes atnodieal etalptartise payntrec throaghan insteaatcr policy or adrerwico fur the benefit afa prerririoaer.

itnedical malpractire payment — a monotony exrbasor asarcsa Ito Iasetnitmenc orjttdensrt,n oft snitee camplaiat or claim demanding paytnert based on a phytsicinnt’s,derld,t’s, or othor lirenned heal’It care pomrtttianee’s pmrisian afar failnmo to provide healthcare aerrieos, and may include, balls sot limbed no, the hUng ofa erase afactiet. based onthe lane aDorn. hraagls inane Stale or t°edomi Coattor onheradjsdieatice body

Medical Malpractice t’aytncat Report — the format toed by mrdi rat malpractice parors toreport a medical ntaipracatce pa~ ntcor trrrdr fee thebrselitofa phrsicias, dentist, or miterhealth care practitioner.

t’iPDB-lllPDB Cnstnntcr Service Center — Eto Cuosmcr Son-ice Centerercompasses alltools a’sd seniors that the Data Bant,s sac to support customers. Qaoaions may be

‘rcrrrdto Infarmatian Specialists at alto Custotoer Sen-ire Center by e-mail ntasjsdhbgizrhgseac’moor by pltoneat t.tOe-767-6732 (TDD 1-703-002-0305).

Occepatinuirield oftlcennare Codes— a tistof occupational activitiestlieensatseategacies fssr lseatth care praceitioacrs. providers, ted sappliers. tad ‘Ito codes med ctidentify thers.

phynietao — a ducrera fmod,cimo or earenpath0’ who in realty authorized to practicetttedicieoorsorgeay by a Stile. orvslto. ~-ithatl astharita-, halds himseil’or harunifoan It’ hono eathotized.

Portable Document Format (P01’)— files will, a .pdfesteavion, sash as Adohc AcrehatReadeofties. FonnatttsrdforNPlatiqneryaadn,pvsrtrespottsgsaadothorfraasaccessedvIa ni,r IQRS.

prnetitianer —‘ n phvoiciar. dentist or other licensd hraltrt core pmclidaacc.

Privacy Art — bela”- that estab unItes safes_a~ for the pmtrrtiro of Fedutal systems ofrecoals he (lavemmeor eallects mod keeps ott iedivi duot persom. SeelitelofoosaarioaSources ctsaptcr ofttsis GtsiUehtaat

prafescloanai rrriewaerian — an action en recommendation aft health care oaiityt

(I) takvts in the c010ea fprofrssierol review activity:

(21 based os the omfeasicoal ceotpet.ersce or prafesaicsoai eoadces ofata iodividaal physicist,dentist, or,sther bra irIs carl practiniaocrwlti ch nll’cco or c-ott Id affect ads ersely rite healthorrselfaae oVa parieocor ~lionto~ old

(3) sviairit cdserselr afferts or may ad’•~ol~~ atiect the cynical pricitegos afthe ptsasivian,dentiti, or otlror health rate ptaeli tiarer.

(4) This term oscladcs acuioar which arc primarily based an: (a) site physician’s, dentist’s. orother health ea~ pncti~anet’s assoniadot. or lack of a050ciaaioa, with n prafesnional

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Or5vtars A rbatac- trto Gaidetsots

snciotyarcsraciatiac; IN ttte gohysicim’s, dertiso’s, or otirro health mm prnetiti user’sfrm or the phytielan v deslist’c, or other itealtla earn pracsilieaer’s adcrrtising oreaoariaoinoihcrcampetitireacrsitsnended to safcic or retain business’, (ci Isaphysician’s, dentists, orothce health rare poaetilionor’s participation in prepaid grouphealth plans, salaried employment or any othermatner ofdetiver(eg health services,sltetineronafer-far-senire or rthrr basis; (di a physician’s, dentist’s, or other itoalthcare pmciliasen’s aosaciaa’srnsvitlt. sspersisios of,delrestiosofaarlrotily Ia, soppoatfee, Imisino of, or participation inaprt’vate gnOOp pmcnice with, a member erooenthers ofa patlicalnr clms ofltralth cab practitioner or prefcssiostai; or N) any oll:sr matter thatdoe, can relate lathe pmfessional competasce or profesnional canduct ofa pitysiciant.dentist rr other hralttt care pmctltiosrr.

pcnfeasional rovient activity — an aulivity oVa health care caytty snitit respect tsarirdiridool phosieiao, dentist, or other health care practitioner-. (I) tIc drlrsniae whether thepltsoieiain, dendas, or other health care ptactiiiotttr may have cliaicat privileges with respectto, or membership in, the entity; (21,0 detenaittetltescope orcoodiiianrofsarlt prt’vilogrsor mete beeship: or 13) to change or modify such privileges or ttrmheeship.

ttrofrtsianalaaclel)’ — an asooeiaai on afphssiciass or dentists that follasys a faitnol peerrer’scvs- process foralte porpose affartiseriog qaafty health care.

QPRAC — sofissoos previsasla as,ailsblc from the NODS tharallossed efrihleemitioa to(acm and report rlecnaocicslly eititerv,a teiss ark teleeom,ttoticscior sniog a atadont or ondishetten sabminod by mail- QPRAC has beer replaced by the IQRS,

tjaety— a mqnesr fanisfonrsation sahmittrd lathe NIsOB by an eligibleeatdty arasthatteedsgcntvia the IQRS or CD format

crpsrr — record ofantedical malpractice payment or adverse nelian submitted to the NPDBby at eligible entity, Reports mty he sshnticed rio the IQRS or by ITP sling lie appraprt’otelCD format

In Action — an oetirc relation to and modifying ant adrerse aclian prrs’ioosistreported m the ?OPDB. e~Reviston Ia Action dmn tat stperscslr a preciously reposedadccrse action- A It entity that reports an Initial oduerse action mast also report arty revisionno that senor.

Senrclaty — the Secrolon)’ afflzaltss sod H aaron Seas-ices.

Secretariat Rcclow — the roconase pros’tdod a pmctis’oaer is the evest nltac hror shedirpates Import to the NPDB attd the reporting eaaity (I) declitses Ia chance the report or(2)dres can respond- The Secrera,~c ofHHS oill review thecasoasd detennise whelherthereport ia faoamlly accnmae or sltnald hove horn reported to the NPDB.setf’qaens — a ssbjrcn’s roqaest for isfamtatiaa mobbed in the NPDS-HIPD1J ohoathimselforhrrsrlf. All oclf-qaeay mqsests toe antoursticallv; sobmired to bath ha NPDB andthe 111008, A uelf’qsery nosy net be sort to only one Data flank,

State — ‘Ito so Stairs, the Disteirt efCobstnbts, Puerto Riro, the Virgin taiattd.s, Guam,Anseriran Somna, and the Nealtern Mar’taon Islands.

State tieetsata e laaard — a generic torts ased to refer a Scale ntedieal aad dcalal buarda. aswell astitoge bodies rosponaibte for hocusing other iteath cute pmrtiiiotera,

Slate mmtirai re dental board — a board afmeslical 000aas’tnors.

nnbj’eetu ralrcticae — a statement ofsp to 2,005 clounscrert tinclcditg aptees codpaactaatianl or less submitted by a subject praatitiotoee reeardittg a oopotst orolaived is thrN POrt.

Volti — ereroecriolt sofa repsorn in its ortiroty-. Veided reports am sat disclosed in responseto qocrier,inc luding setf-qttcr’rs by practitiottels. Reports maybe voided oaiy by horeport’tog ettlstf or titr Secretary- of HHS dtraaeh Secretarial Reviess’,

11 Caste or Federal Regulations Part Ot (45 CFR (Ito — ttedotol regoistians nltat governthe NPDIO. See e5ppeodrc B.

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APPENDIX B: Lawn and Regulations

The following laws and rogolauionu apply Ic lie National Peaciitioner Data Bunk. The fulllesteunbe acceooedbyclick’mgthessebsitelitikne,a lacuch,

lutk it’ofPublic Low 99-660, complete cent ufihu Health (‘an’ Oiaoll9’ fiiipa’urenietit 4cr of9994. autniended. htr~ th.’t,wnpnth-injndh,runualtoaeginlorion’ucokq,html

nile Jvloegeitooiorua. complete toxIc I lie 45 CPU Pals fit, October II, 900.hllp:,St’wr’.,ipdb4npdb.eounciqfnt!egtnlnoioitc4scfroo.hnol

Clint .tfoi,eu Pcnal*a, 42 CFR Pad 1003.hor,.’hi’aar. tipdb’hi,db.eoaxu,tfna,’gce?arloo°4,2ef, loot?

Feeedninofbi(oinixooinn dee (P0/A). 111° proviiionsofFillh, S USC 0552, siTed he‘Ii semLnalion of in Inmution contained lottie NPDB.hllpndrasrr,alb-hynth.rom,?ofua,Yegt,loiooii’gtkahlpil

Petl’uq’AcrnflP’J;:lheroidoniofsysoe,nrfllccoods.TheP,k-aca’Jc, alittctnthedinteuninailon of isloronatiex cnnlat’oued in the NPDB. Please rofeacaco Ito Pritaci’ Act.S USC §552a houp: a o-w.npdb’hlpcJs.roitx’htfe,lcginlotjoitn°pflu-u0’hotn(

Final nile in the Federal Rrgisor en Mucch I, 1999,thg cantos the prohibition against ItoNODS changing for ieIf’qnetiet. otod thorelorn, allows 0, NPDB in sanest COILS itt anequitable manner. hnp-onocnacinodb.hQ’db.couc)nuhs.fe&egd.?.9944’

Notice iii die Federal Rrglnlcron March I, 999, announcing a $10 fee for health coatpoactilioners oho reqnosl inl’ormation about llieeusrlres (irIl-quei~’) from tile NPDIO.elTeclise Mnreli 3. 999. hllpniotcepoth’hipain.em,n4nt,ln5eeh’egi’l’99.pgi

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APPENDIX C: AI2bi’eviations

PAR AdveneAcdon ReponBlUr Buresue IHeabh ProfessionoCFR Code ci’ Federal RenulalionsCMS Centers Icr Medicare & Medicaid Sersinci (fenateclo, the Health Case

Financing Adoninictralion)DBID Data Bank Identificalion NumberDCX Data beak Cunool Number0th Den Enfxncemeni AdmininnationDQA Dirisien ulGomlity AnstonaneeOFF lilecteonaic Fundn’FraanfeeFOIA Freedom of lnloraaaiiooa AcFills (IS. Deparlnieiitofllenlth and Human SmutsHIPOS Flealtheame merrily and Protection Data BenkHMO I lealtlt ti ninlettance OrganioaiiotnHRSA lleatth lOesonreca and S ersicea AdositistraitenCD Intoiface Conical Doconient

ITO lCD) Transfer Prrtoe,nlIQRS lxlegnated Qucnn,ine and Reponueg SrroieeLOP Lotthdjuslmeni E’upenseMCD Managed Care OrpanizationMMER ,‘sledicaootMedicaid Exclnnion RepsnMMPR Medical Med practice Payment RepeatNPDB iiotioa,l Praaalilionrr Data BankDIG Ollimeollntpocicr DeneralJHHSPOP Paeable Docitmeni FilePPO Preferred Pcasider OrganizationQPRAC Qaersott Poacliti anonRVD Repo~Veri~co~on DocioneniSliD Snbjoni Netiliroiton DocumentSON SocialSrcnrhvNiimberTDD Telecommunications Drvice far tin DealuN Tnspa;-erldritiiricntien Nnmbcr

iirlan,bn, Sent Aopn’d’a C’e