Meeting NPDB Reporting Requirements When Navigating a Peer Review Matter
Peer Review Organization Reporting Obligations and Healthcare Provider Strategies

Course Details
- smart_display Format
On-Demand
- signal_cellular_alt Difficulty Level
- work Practice Area
Health
- event Date
Thursday, March 30, 2023
- schedule Time
1:00 p.m. ET./10:00 a.m. PT
- timer Program Length
90 minutes
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This 90-minute webinar is eligible in most states for 1.5 CLE credits.
This CLE webinar will guide healthcare counsel on NPDB reporting requirements and compliance when navigating through and settling a peer review matter. The panel will address compliance challenges involved with a peer review matter and will offer best practices for meeting the reporting requirement.
Faculty

Mr. Eades devotes his practice to medical staff governance, credentialing and peer review. As part of his practice, he regularly counsels clients on matters involving medical staff bylaws, accreditation standards, hospital licensure rules and the Medicare Conditions of Participation. Mr. Eades is routinely engaged by the firm's clients to assist with the drafting and implementation of Quality Assurance and Performance Improvement processes, peer review sharing arrangements, FPPE/OPPE processes and other medical staff policies and procedures addressing the conduct and competency of healthcare providers. Peer review confidentiality and peer review immunity are critical to effective hospital and medical staff quality review.

For over 30 years, Mr. Zarett has focused his practice on the representation of healthcare provider in state and federals courts, arbitration, and before numerous administrative bodies. He handles all phases of state disciplinary investigations and proceedings, medical staff privileges matters, and resident physician and fellow grievance matters, among others. Mr. Zarett is an adjunct professor of law at Fordham Law School, where he teaches a class in Healthcare Law and Policy.
Description
The NPDB reporting guidelines set forth requirements with the potential to affect any licensed healthcare provider after an adverse action or malpractice payment. The guidelines include many exceptions, however, and whether report of an adverse action or payment is required should be evaluated on a case-by-case basis.
There are many circumstances when it is not clear whether or not to file a report. Some NPDB reporting guidelines apply to healthcare practitioners other than physicians. Licensed healthcare providers should be aware of the applicable reporting requirements in the event of an adverse action. Eligible entities are required to report adverse clinical privileges actions taken against physicians and dentists and may report adverse clinical privileges actions taken against other licensed practitioners.
Peer review organizations must report certain negative actions or findings, which are defined as any recommendation by a peer review organization, based on formal proceedings of the organization, to sanction a licensed practitioner. However, it is important to note that not all healthcare organizations using peer review qualify as a peer review organization under the guidelines. Understanding who is a qualified reporter and what should be reported and when is critical.
Listen as our authoritative panel of healthcare attorneys examines NPDB reporting compliance when navigating through and settling a peer review matter. The panel will address compliance challenges involved with a peer review matter and will offer best practices for meeting the reporting requirement.
Outline
- NPDB reporting requirements
- Challenges involved with peer review matters
- Best practices for NPDB reporting compliance
Benefits
The panel will review these and other relevant issues:
- What are the critical reporting changes in the NPDB guidebook?
- What complexities arise when there is a peer review matter being settled?
- What steps can counsel take to ensure compliance when there is uncertainty about reporting?
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