Firm News & Legal Alerts

Monday, October 1, 2012

Recent Healthcare Law Developments: Court Affirms 2004 Ruling

Court Affirms 2004 Ruling that Healthcare Providers Can Challenge Inaccurate National Practitioner Data Bank Reports Pursuant to the Federal Privacy Act.  As a physician, learning that you are the subject of an Adverse Action Report filed with the National Practitioner Data Bank (NPDB) is distressing, to say the least. It can have significantly negative ramifications on a physician’s professional practice and reputation.  The NPDB is a federal clearing house, maintained by the United States Department of Health and Human Services, which collects information on every physician who has been the subject of a medical malpractice payment, adverse medical staff privileging action, Board or Professional Society discipline and/or state licensure penalty. Whenever a physician seeks to obtain or renew his/her professional credentials, such as for a medical license, hospital privileges, or malpractice insurance, the NPDB is “queried,” which in turn could lead to adverse credentialing decisions.  Needless to say, these issues are particularly upsetting if the physician believes the original report filed with the NPDB was inaccurate or misleading in the first place.

While the NPDB has built in administrative procedures to contest the posting of an Adverse Action Report, some physicians have taken the challenge a step further and gone to federal court to try to have these reports either modified or voided altogether.  The 2004 case of Doe v. Thomspon, 332 F. Supp.2d 124 (D.D.C. 2004) is a good example.  The United States District Court, for the District of Columbia, held that a physician could challenge an Adverse Action Report under the Federal Privacy Act (U.S.C. § 522a) (the “Act”).  The Doe Court held that the Act requires a government agency, “prior to disseminating any record about an individual to any person other than an agency [such as HHS and the NPDB] ... [must] make reasonable efforts to assure that such records are accurate, complete, timely, and relevant for agency purposes.” See, 5 U.S.C. § 552a (e)(6).  Unfortunately for the provider in Doe, the two-year statute of limitations for filing an Act cause of action had expired, and his case was dismissed.


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