Which of the following is NOT reported to NPDB?

Which of the following is NOT reported to NPDB?

• A. Private health insurance claims
• B. Medical malpractice payments
• C. Adverse licensure actions
• D. Peer review actions

Answer: (A)

The information evaluated by the NPDB focuses on actions that affect patient safety and a practitioner’s ability to practice, such as malpractice payments, adverse licensure actions, and adverse actions related to clinical privileges or peer review. These types of records directly reflect professional conduct and the potential risk to patients, which is why they are reported to the NPDB. Private health insurance claims, by contrast, are billing or reimbursement data rather than indicators of professional discipline or patient safety events. They do not reflect judgments about competence or actions that would trigger licensure or privilege restrictions, so they are not reported to the NPDB.

The information evaluated by the NPDB focuses on actions that affect patient safety and a practitioner’s ability to practice, such as malpractice payments, adverse licensure actions, and adverse actions related to clinical privileges or peer review. These types of records directly reflect professional conduct and the potential risk to patients, which is why they are reported to the NPDB.

Private health insurance claims, by contrast, are billing or reimbursement data rather than indicators of professional discipline or patient safety events. They do not reflect judgments about competence or actions that would trigger licensure or privilege restrictions, so they are not reported to the NPDB.