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national practitioner data bank

We are frequently asked if there is a threshold dollar amount before a carrier must report a settlement to the National Practitioner Data Bank (NPDB), a federal entity? Some doctors think the amount is $30,000. (Note, the threshold for reporting a settlement online varies from state to state. In California, a settlement over $30,000 is reportable to the State Board of Medicine and it will be published online. That’s why some people think there is a dollar threshold for reporting to the National Practitioner Data Bank.)

Others believe it is over $100,000.

Here’s the sad truth. If a carrier makes any payment to a plaintiff on your behalf in response to a written demand, that is reportable. The carrier must report to the National Practitioner Data Bank or it risks being fined $23,331 per incident. I have no idea how that number, $23,331, was calculated. But a carrier has a strong incentive to report any payment. And any payment, even for one measly dollar, is reportable.

That said – can a payment be made to the National Practitioner Data Bank that is not reportable?

Yep.

Here are some circumstances.

If you, the doctor, make the payment out of your own pocket, it is not reportable to the National Practitioner Data Bank.

There are some exceptions, but that conclusion mostly holds true. This strategy may make sense if the settlement is modest, for example, under $10,000.

Next, if there was never a demand made in writing, a payment is not reportable to the National Practitioner Data Bank.

Obviously, if a patient files a written lawsuit, this strategy is foreclosed. But on occasion, an attorney will pick up the phone, make a demand, you believe it is not unreasonable, and your carrier agrees to make a payment. That is not reportable. It would be unusual for a carrier to make a payment without a written demand. But we’ve seen it happen.

If there are multiple defendants and a payment is made by your carrier, there is one circumstance where that payment is not reportable to the National Practitioner Data Bank.

You might ask how a payment can be made by a carrier in response to a written demand and still not be reportable.

I see you paid attention to the items above.

If you find yourself in this situation, call us: 1-877-633-5878.

I am referencing a strategy we have used several times to prevent reporting to the National Practitioner Data Bank, or if the carrier still reports, as it sometimes will do, to successfully petition the National Practitioner Data Bank to remove that nasty line item.

The phone call is free: 1-877-633-5878.

Risking a report with your name without considering the consequences or options can cost you in the long run. Use the resources below to contact us. 

About the Author

Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal is a board-certified neurosurgeon. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.

What is Medical Justice?

In 1998, founder and CEO Dr. Jeffrey Segal developed the concept of Medical Justice while practicing neurosurgery. His vision is a unique approach that forms part of our two-pronged strategy: to deter the filing of frivolous medical malpractice lawsuits and to enable viable responses and remedies from wrongful suits against physicians. We filed our first patents in 1999, and with the signing of our first distribution agreement in 2002, Medical Justice commercialized our proactive professional liability service.

Today, Medical Justice has assisted over 12,000 physicians in the US. We create a practice infrastructure to prevent, deter, and respond to frivolous medical malpractice suits. We offer prospective and retroactive service plans that enable “points forward” service as well as optional benefits as far back as residency. Medical Justice supports a broad group of medical specialties and is endorsed by many state, county, and specialty medical societies.