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NPDB Compliance Review Process

The Health Resources and Services Administration's (HRSA's) Division of Practitioner Data Bank (DPDB) reviews the completeness and accuracy of reports submitted to the National Practitioner Data Bank (NPDB). We gather data regarding disciplinary actions taken by State licensing and certification agencies (State licensing boards). This data is compiled and compared with the actions submitted by the boards to the NPDB.

The results of the analysis are posted on the NPDB website. Visit the Reporting Compliance by State page to see the current compliance status for each state and profession. Previous postings are available on the Compliance Results page.

Steps to Ensure Your State Licensing Board is Compliant

Complete these steps to achieve and maintain compliance with NPDB reporting requirements:

  1. Renew your NPDB registration when you are notified to do so. Every two years your board must review and verify that your registration information is current and correct.
  2. Review the list of professions that your board regulates, verify that this list is complete and accurate, and add or remove professions if needed.
  3. Attest to your level of reporting compliance with the NPDB's reporting requirements. Review the list of reports submitted during the attestation period for each of the professions your board regulates. Review the actions your board has taken over that same period and determine if your board submitted all required NPDB reports of those actions.
  4. Review your compliance summary to ensure that your board has met all NPDB reporting requirements. If your board is under review, you may see a data request , Professions with Compliance Actions You Must Resolve , and/or Professions with 100% Compliance .
  5. Continue to submit reportable state licensure actions to the NPDB as required by law.

Refer to the NPDB Guide to Reporting State Licensure Actions, NPDB Guidebook, and NPDB regulations for more information.

How does the NPDB conduct a compliance review?

The NPDB reviews your organization's attestation and reporting activities intermittently. If your board is selected for an adverse action comparison review, the NPDB evaluates adverse actions published on your organization's website that were taken during the review period. We review the actions to determine if they are reportable, then compare the reportable actions with NPDB reports submitted by your board. We use a match rate formula to evaluate the results and assign a compliance status for each profession in the review.

# NPDB reports / # Reportable actions = % Match Rate

Compliance Status Assignments

The NPDB assigns a compliance status to each reviewed profession based on the match rate.

  Compliant
(100% match rate)

Your organization's compliance performance meets the highest standards. All reportable actions in the review matched with a submitted report.

  Compliant with Actions to Resolve (95% or higher match rate)

Your organization's compliance level for the profession is acceptable, but does not meet the highest standards. Some actions did not match with a submitted report and must be resolved to achieve 100% compliance. Your NPDB compliance officer will work with you to reach this goal.

  Not Compliant
(less than 95%)

Your organization's compliance level for the profession is not acceptable. You must immediately review and resolve all unmatched actions by the due date shown on your compliance summary.

If the profession is still not compliant after the due date, the NPDB will publish a compliance status for the profession on the website as non-compliant, working towards compliance, or under review.

Your NPDB compliance officer will work with you to achieve 100% compliance for all professions.

Example of a Compliance Status Assignment

The NPDB reviewed Board A's website and found 12 reportable actions taken against physicians during the review period. NPDB matched 10 of these actions to submitted reports.

10 NPDB reports / 12 Reportable actions = 83% Match Rate

Since the match rate is below 95%, Board A's compliance status for physicians is assigned as "Not Compliant."

 

Hospitals and other health care organizations submit queries to the NPDB when making decisions regarding employment, credentialing, and privileging health care practitioners. We include professions that organizations identify most often in their queries:

  • Physicians
  • Dentists
  • Nurses
  • Physician Assistants
  • Social Workers

The NPDB randomly selects additional professions to include in adverse action comparison reviews.

 

Sign in to your NPDB account to check your compliance summary page. Review the actions you need to take, and your due date to respond. If your board designated an agent to submit NPDB reports on your behalf, your compliance officer will work with your agent to respond to compliance actions on your behalf.

There are two actions that require a response:

  • Data Required: If you see a data required notice on your compliance summary it means that the NPDB could not find public data from your website regarding disciplinary actions taken by your board for certain professions. Follow the instructions to complete a data worksheet and return it to the NPDB by the due date on the notice.
    The worksheet information must include all actions that are reportable to the NPDB for the time period under review for the requested professions on your notice.
    Reportable actions include those that revise prior actions, such as a reinstatement or change in the effective dates of a suspension. For details regarding reportable actions visit NPDB Guide to Reporting State Licensure Actions.

  • Unmatched Actions: If the NPDB identified a disciplinary action and could not match it to a submitted NPDB report, the action is unmatched and must be resolved by the due date listed. There are three ways to resolve an unmatched action:
    • Submit a report of the action to the NPDB.
    • If the action was reported, provide the NPDB report number.
    • Provide information from NPDB regulations proving that the action is not reportable.

 

If your compliance summary page shows that data is required:

  • Select the link displayed on the page to go to the Data Request Worksheet (XLSX - 16 KB).
  • Complete the worksheet as instructed and save it to your computer.
  • Use the upload feature on the compliance summary page to send the completed worksheet. The NPDB receives your worksheet as soon as it is uploaded.

The completed worksheet must be received before the due date listed on your summary page. Failure to do so may result in your board being posted as non-compliant on the NPDB website.

 

The due dates to return the completed Data Request Worksheet (XLSX - 16 KB) and to resolve unmatched actions are shown on your compliance summary page.