QUESTION: Our Medical Staff Bylaws contain a provision stating that Medical Staff members automatically relinquish their appointment and clinical privileges if they lose their license or fail to meet other threshold eligibility criteria. Do we have to report such automatic relinquishments to the National Practitioner Data Bank (“NPDB”)?
ANSWER: You do not. By way of background, we generally recommend that Medical Staff Bylaws documents identify certain events that will lead to the automatic relinquishment of appointment and clinical privileges. This includes, among other things, failure to meet any threshold eligibility criteria that are required for appointment and clinical privileges. When a member’s appointment and privileges are automatically relinquished pursuant to such a provision, the action is considered to be “administrative” in nature. That means there is no “professional review action” as defined by the Health Care Quality Improvement Act, so there is no need for a report to the NPDB. The latest edition of the NPDB Guidebook includes the following question and answer that addresses this specific situation (See page E-47):
Question: A hospital automatically revoked a physician’s clinical privileges when the physician lost her license. Should this action be reported?
Answer: No. Administrative actions that do not involve a professional review action are not reportable to the NPDB. The revocation of clinical privileges is automatic because the practitioner no longer holds a license. Regardless of the reason for the State medical board’s licensure action, the hospital’s revocation of privileges was not the result of a professional review action. Therefore, the hospital’s action should not be reported to the NPDB.