National Database for Malpractice Claims

In a Department of Health & Human Services (HHS) decision, all medical malpractice claims involving exchange of payment or compensation must be reported to a federal database of malpractice claims. The HHS decision was released in response to two state laws, according to Modern Healthcare.

The states involved were Massachusetts and Oregon. These states have laws that might have allowed some medical providers to settle malpractice lawsuits outside of the court system and not report settlements to the National Practitioner Data Bank (NPDB).

The “Data Bank,” is a confidential information clearinghouse created by Congress to improve health care quality, protect the public, and reduce health care fraud.  The NPDB is a flagging system to help people review the professional credentials of health care practitioners and entities.

According to the HHS Agency for Healthcare Research and Quality Director, some studies discovered that NPDB reporting requirements reduces medical providers’ participation in “communication and resolution” of malpractice program.

The HHS decision made it clear that health care providers need to report settlements outside the legal system to NPDB for any case that generates “a written claim or written demand for payment.” It does not matter if the payment is made by insurance, hospital, party, or third party.  The payments must be reported even when the provider is determined not at fault.

For Oregon, HHS stated that while Oregon’s law was “explicitly designed to avoid medical malpractice reporting to” NPDB for such claims, “NPBC has no history of allowing states to define requirements for reporting.”

For Massachusetts, the HHS decision focused on the Disclosure, Apology and Offer law.  The Massachusetts law calls for injured patients thinking about a lawsuit to file a “prelitigation notice” and wait at least 6 months prior to court. That waiting period opens space for an out-of-court solution. The HHS decision takes away hope for those in medicine who do not want to be identified as being involved in a lawsuit.

Although HHS’ decision considered the programs in two states, the ruling is precedent for other states, including Florida and Georgia, looking into apology laws similar to Oregon and Massachusetts.

Read the Article Here.