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NATIONAL PRACTITIONER DATA BANK (NPDB)

The National Practitioner Data Bank (NPDB) was established through Title IV of Public Law 99-660, the Health Care Quality Improvement Act of 1986. The legislation was the result of the need to encourage the peer review process and improve the quality of health care. The NPDB began collecting and disseminating information on September 1, 1990. This database contains information on adverse licensure actions, clinical privilege actions, and professional society membership actions taken against physicians and dentists. Additionally, the Data Bank collects reports of medical malpractice payments made on behalf of health care practitioners.

HEALTHCARE INTEGRITY AND PROTECTION DATA BANK (HIPDB)

The Health Insurance Portability and Accountability Act of 1996 led to the creation of the Healthcare Integrity and Protection Data Bank (HIPDB). HIPDB is a national health care fraud and abuse data collection program for the reporting and disclosure of certain final adverse actions taken against health care providers, suppliers, or practitioners. Final Adverse action includes:

  1. Civil judgments against a health care provider, supplier, or practitioner in Federal or State court related to the delivery of a healthcare item or service.
  2. Federal or State criminal convictions related to the delivery of a health care item or service.
  3. Actions by Federal or State agencies responsible for the licensing and certification of health care providers, suppliers, and licensed health care practitioners including:
    1. Formal or official actions, such as revocation or suspension of a license (and the length of any such suspension), reprimand, censure or probation.
    2. Any other loss of license or the right to apply for, or renew, a license of the provider, supplier, or practitioner, whether by operation of law, voluntary surrender, non-renewability, or otherwise.
    3. Any other negative action or finding by such Federal or State agency that is publicly available information.
  4. Exclusion from participation in Federal or State health care programs.
  5. Any other adjudicated actions or decisions that the Secretary shall establish by regulation.

Information from the HIPDB is available to Federal and State government agencies, health plans and via a self-query for health care providers, suppliers, and practitioners. This information is not available to the general public. Information reported to the HIPDB is considered confidential and is not disclosed except as specified in the HIPDB regulations.

The subject of a report may dispute only the factual accuracy of the information contained in the HIPDB report concerning the individual. The Secretary will not review issues regarding the merits of the case, or the due process that the subject receives. The dispute process will afford the subject an opportunity to bring relevant factual information, including reversals of criminal convictions by an appeals court, to the attention of the reporter. If the reporter does not revise the information within 30 calendar days, the subject can request that the Secretary review the matter. After review, the Secretary will remove the dispute status, correct the information, leave the information unchanged, void the report from the HIPDB, and/or add a statement to the report.

As of February 1, 1999, the Alabama Board of Nursing was required to begin reporting all adverse actions to the HIPDB. The Board was also required to report historical data from August 1, 1996. If you should receive a report with incorrect information, please submit a copy of the report to the Board. The correct information will then be submitted to the HIPDB.


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 1-800-656-5318  |  Alabama Board of Nursing P.O. Box 303900 Montgomery, AL 36130-3900