COMMENTS REQUESTED FOR NATIONAL PRACTITIONER'S DATA BANK IMPLEMENTATION ISSUES OPERATION SERVICES IN SUPPORT OF THE 3rd GENERATION OF THE NATIONAL PRACTITIONER DATA BANK. The Division of Quality Assurance (DQA), in the Bureau of Health Professions (BHPr) of the Health Resources and Services Administration (HRSA) is preparing for the recompetition of the operation and maintenance of the National Practitioner Data Bank (NPDB). Title IV of Public Law 99-660, the Health Care Quality Improvement Act of 1986, as amended, was enacted to encourage greater efforts in professional peer review and to restrict the ability of incompetent practitioners to move from State to State without discovery of previous substandard performance or unprofessional conduct. To encourage and support professional review activity of physicians and dentists, the law offers immunity to professional review bodies of hospitals and other health care entities, and persons serving on or otherwise assisting such bodies from private damages in a civil suit under Federal or State law (except for civil rights actions and antitrust actions brought by Federal and State governments). For this immunity to apply, a professional review action must be taken in the reasonable belief that the action will further the quality of health care and provide specific due process safeguards for the physician or dentist. Title IV also established the NPDB to collect and release certain information related to the professional competence and professional conduct of physicians, dentists, and other health care practitioners. The NPDB impacts the health care practitioner credentialing process by making information available to eligible entities and individuals on medical malpractice payments made on behalf of physicians, dentists, and other licensed health care practitioners, and adverse actions taken against physicians and dentists by State licensing authorities, hospitals and other health care entities, and professional societies. Final regulations governing the NPDB are codified at 45 CFR Part 60. Responsibility for the operation of the NPDB resides in the Division of Quality Assurance (DQA), Bureau of Health Professions (BHPr), Health Resources and Services Administration (HRSA), Public Health Service (PHS), U. S. Department of Health and Human Services (DHHS). The NPDB collects and releases the following information to qualified entities as it relates to the professional competence and professional conduct of physicians, dentists, and, in some cases, other licensed health care practitioners to eligible parties: a. Medical malpractice payments resulting from a written claim or judgment; b. Adverse licensure actions taken by State medical and dental boards; c. Professional review actions taken by hospitals and other health care entities that adversely affect clinical privileges for a period longer than 30 days; or voluntary surrender or restriction of clinical privileges by a physician or dentist while under or in return for not conducting an investigation relating to possible incompetence or improper professional conduct;d. Professional review actions taken by professional societies that adversely affect society memberships. e. Practitioners who have been sanctioned by the Medicare Program. f. Physicians who have had their script writing privileges revoked by DEA. The NPDB Project Officer, Elizabeth Downey, requests industry's comments (opinions and/or suggestions) for the best method to implement the following items: 1) matching algorithm; 2) report submission; 3) billing; and 4) security of the NPDB files (in an electronic environment, e.g. Internet). Other topics may follow as a result of the input from industry. Preliminary information can be found at the NPDB Web Page. This Web page address is http://www.hrsa.dhhs.gov/bhpr/dqa. The Division of Quality Assurance will be seeking industry's opinions and/or suggestions on additional technical issues of the NPDB (including proposed SOW) via the web page. Notification regarding the RFP package and prebidders' conference will be transmitted at a later date.

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