National Practitioner Data Bank: New Secrecy Rules

The National Practitioner Data Bank (for short: NPDB) is an electronic repository containing doctors’ malpractice settlements and judgments that the feds have maintained for 15 years. It also includes adverse peer review actions against licenses, clinical privileges, and professional society memberships of physicians and other health care providers and Medicare and Medicaid exclusion reports of sanctions against doctors for fraudulent billing.

This database – while not as complete as it should be – has been a huge weapon on both sides of the malpractice debate to separate fact from fiction. Federal law dictates that all medical liability payments and certain adverse actions must be reported. The NPDB makes some of this information available to hospitals, state licensure boards, some professional societies, and other health care entities under certain prescribed circumstances.

The public also had access to the database until this month when the government shutdown public access to this data. The public never had unfettered access but the NPDB has long been providing access to its reports with the names of the doctors, patients and hospitals redacted.
What happened? Newspapers were using the NPDB to connect the dots to figure out the names of the parties – mostly hospitals and frequent flyer malpractice doctors. Local newspapers do a number of “Can you believe this doctor had 9 nine malpractice cases against him while he was treating y’all?” stories a month.

Specifically, the Kansas City Star was running these types of stories and using the NPDB to match facts it knew with the redacted reports in the database. “We’ve seen (The Kansas City Star’s) reporting and others that show your ability to triangulate on data bank data. We have a responsibility to make sure under federal law that it remains confidential,” said Martin Kramer, spokesman for the Health and Human Services Department’s Health Resources and Services Administration, the agency that oversees the data bank.

According to Kramer, the NPDB may try to make the public-use files available again after they try to figure out a way to produce the data with less opportunity for reporters and others to connect the dots. I have no idea how this would be possible: to reveal less and still provide the same information.