During the course of a year, the attorneys at Fager Amsler Keller & Schoppmann, LLP, counsel to MLMIC Insurance Company, handle approximately 5,000 questions from policyholders on professional liability, risk management and healthcare law. Frequently, the questions asked by healthcare professionals involve requests for legal guidance on the National Practitioner Databank.
Here, we’ve paired the FAQs on medical professional liability related to the National Practitioner Databank with the attorneys’ responses.
I am a co-defendant in a malpractice lawsuit. If my insurer pays money to satisfy a settlement or judgment on behalf of my co-defendants, but does not make a payment on my behalf, will I still be reported to the Data Bank?
No, the National Practitioner Data Bank only requires your insurer to report indemnity payments made on your behalf as a result of a written claim.
Is an incorporated solo practitioner considered to be an entity for purposes of reporting to the Data Bank a payment he/she made?
No, regardless of the form under which you practice as a solo practitioner (for example, you may be operating as a P.C.), individual practitioners are no longer required to report to the Data Bank payments they make on their own behalf personally out of pocket.
Must I permit HMOs, other insurers and hospitals to query the National Practitioner Data Bank?
HMOs and group medical practices qualifying as entities under the Data Bank plan because of their professional and formal peer review activity may query the Data Bank. Hospitals must query the Data Bank when a physician, dentist or other qualified healthcare practitioner applies for a position on the medical staff or applies for a change in clinical privileges. Hospitals must also query the Data Bank when re-credentialing members of its medical staff. The initial inquiry must be done no later than two years after the opening of the Data Bank and every two years thereafter. An insurance carrier cannot request information from the Data Bank.
Will I be notified by the Data Bank if an inquiry about me is made?
Practitioners can receive copies of their complete file at any time, free of charge, by submitting a Request for Information Form to the Data Bank. Healthcare practitioners are not automatically notified when a report is released on them in response to an inquiry but may periodically obtain this information by requesting a copy of their Data Bank file. Practitioners are only notified when they are the subject of a report received by the Data Bank.
Is there a minimum threshold of loss payment that does not require a report by my carrier for a settlement made in my behalf?
No, all payments made after September 1990 on behalf of a practitioner are reportable to the Data Bank.
The attorneys of Fager Amsler Keller & Schoppmann, LLP (FAKS) perform thousands of hours of professional liability services per year. They are uniquely qualified to assess medical-legal issues and provide counsel to minimize liability exposure. MLMIC policyholders can reach 24/7 legal support services by calling (855) FAKS-LAW or emailing hotline@FAKSLAW.com. For more information about these services, offered exclusively to MLMIC policyholders, visit our web page on Legal 24/7.
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