Notable revisions to the Guidebook include the fact that each of the following situations is now identified as a reportable change in a practitioner’s status:
- “Acceptance of the surrender of clinical privileges or any restriction of such privileges… while under investigation.”
- A leave of absence while under investigation that restricts privileges.
- A reappointment review in which officials at the reappointing hospital have specific concerns about the practitioner’s competence based on the number or severity of medical malpractice cases.
- A Quality Improvement Plan that:
- is the result of a provisional review action regarding competence or quality,
- restricts privileges, and
- remains in place after 30 days.
- A requirement that a surgeon operates only with a qualified first assistant if the requirement is:
- imposed on a specific surgeon,
- a professional review action about competence and conduct, and
- in place after 30 days;
- A restriction that is in effect for more than 30 days, regardless of the stated length of the restriction. (For example, a restriction on the surgeon’s next 5 bowel surgeries which ends up lasting more than 30 days.)
- An adverse action that is the result of a private agreement between a provider and state agency.
- An enforceable agreement signed by a board that an impaired practitioner will not practice, is in “inactive status,” or other voluntary agreement not to practice while under investigation or in exchange for not conducting an investigation.
- Payment by a sole shareholder professional corporation relating to conduct by the shareholder physician or identified staff.
The October 2018 NPDB Guidebook is available at https://www.npdb.hrsa.gov/resources/aboutGuidebooks.jsp.