ISMIE's Approach to NPDB Reporting Requirements

When a claim payment is made on behalf of one of our policyholders, the National Practitioner Data Bank (NPDB) requires us to submit a report within 30 days. Failure to do so can result in a fine (up to $11,000) for each missing report.

This requirement is applicable to any physician who is licensed or otherwise authorized by the state to provide health care services. The report is submitted simultaneously to the appropriate state licensing board in the state in which the claim occurred. The reports are required to be submitted whether the matter was settled due to judgment, out of court settlement or arbitration.

As a reporting entity, we must provide an accurate description of the acts or omissions and injuries or illnesses upon which the medical liability action or alleged claim was based.

ISMIE extends the courtesy of allowing you the opportunity to see a working copy of the report before the final report is submitted to NPDB. While we are mandated by law to report, we want you to feel comfortable with the information being submitted.

Within 30 days after submitting the report to NPDB, you will receive notification from the data bank that the report was received. At that time, you are encouraged to submit a reply. This reply can be up to 4,000 characters and can be submitted any time. This response is encouraged as it allows the insured an opportunity to explain the circumstances of the incident being reported. A physician's hospital may view the replies when it legally queries the data bank.