Question

Week 2 Discussion Discussion Topic Due June 1 at 11:59 PM Supporting Lectures: Review the following lecture: Legal and Regulatory Issues Introduction: The 1986 Health Care Quality Improvement Act established a database that is intended to improve the quality of healthcare in this country. Two other databases have merged with it and now offer many potential advantages. Tasks: Describe the National Practitioner Data Bank (NPDB). . Identify the uses of the NPDB. . Analyze any limitations of the NPDB. Describe how NPDB relates to billing for services. Submission Details: To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format. Your initial posting should be addressed in 150-300 words. Submit your document to this Discussion Area by the due date assigned Respond to your classmates throughout the week. Justify your answers with examples, research, and reasoning. Follow-up posts need to be submitted by the end of the week. Week 2 Project B, Assignment

Answer 1

National Practitioner Data Bank is a database with a list of names that assist with peer review of physicians. They collect information about physician’s medical malpractice losses and settlements, investigations into licensure and other damaging professional conduct.

The NPDB was implemented in September 1990 as a response to the need for a better tracking system for Medicare and Medicaid patients under their protection act of 1987. Over the next 20 years from 1987-2007, the NPDB has evolved into a massive federal data bank that serves as the healthcare industries repository for collecting, storing and sharing information about all health care providers in the United States (Burroughs, 2013).

The key provisions of the NPDB require reporting of any and all adverse licensure issues, hospital actions against a provider, or any other professional society actions that have been taken against dentists and physicians as related to the quality of care they provided patients. The NPDB also collects data and tracks all malpractice actions and payments that occur in the U.S. In 2007, additional rules were implemented that added the collection of information on nurses in addition to physicians and dentists. The laws that cover the regulatory affairs of the NPDB are found in; Title IV of Public Law 99-660, Section 1128E of the Social Security Act, and Section 1921 of the Social Security Act (Burroughs, 2013).In addition to the NPDB, the Health Insurance Portability and Accountability Act of 1996 created the Healthcare Integrity and Protection Data Bank (HIPDB) which also served as a tracking system.

The HIPDB alerts users to practitioners whose past actions would warrant further review. The HIPDB along with NPDB information is used to make determinations for practitioner's employment decisions, certifications, licensure decisions, and affiliation criteria

This is supposed to serve as another source for companies permitting clinical privileges. The nurse practitioner must report when medical malpractice payments are made from a claim or judgment in their behalf (NPDB, 2018). Any actions from the Drug Enforcement Administration must be reported (NPDB, 2018). Nurse practitioners must also report any health care-related civil or criminal convictions as well as any actions from the federal government regarding their licensure or certification (NPDB, 2018). These all have to be reported to the NPDB within 30 days (NPDB, 2018). A health care practitioner that does not report these incidences can be subject to thousands of dollars in fines

Limitations:-

• Data for 1990 reflect only reports submitted on or after September 1, 1990.
• Data include reports for the 50 States, the District of Columbia, Puerto Rico, the Armed Forces, and other territories.
• Data limitations exist for various practitioner types based on the historical data reporting requirements that are described above.
• Data for this application are based on the most recent full calendar year processed by NPDB for report purposes.
• Analyses resulting from this annually-updated application may not match those obtained from the Public Use File, which is updated quarterly. The data are aggregated using variables not available in the Public Use File