Options are Available to Minimize the Damage Resulting From Reportable Disciplinary Action

By: Jesse Adam Markos, Esq.
Wachler & Associates, P.C

The recent adoption of stricter disciplinary action reporting requirements by the National Practitioner Data Bank (the “Data Bank”) and the Michigan Department of Licensing and Regulatory Affairs’ (“LARA”) has resulted in a substantial increase in the number of healthcare providers saddled with a career-damaging Data Bank report. Importantly, options are available to these providers to help minimize the damage. More specifically, healthcare providers that are the subject of a Data Bank report have the right to add a subject statement to the report at any time. Although this does not change or correct a report, it does provide a provider with a chance to tell his or her side of the story.

By way of background, the Data Bank is an alert system that collects and discloses certain adverse information about physicians and other healthcare providers. A report to the Data Bank can significantly impact a healthcare provider’s reputation and career. State licensing authorities, hospitals and other healthcare entities, and professional societies query the Data Bank when investigating qualifications. A response that contains an adverse report can result in a denial of credentialing, loss or limitation of hospital privileges, loss or limitation of licensure, exclusion from participation in health plans, and increases in premiums or exclusion from professional liability insurance.

Nevertheless, the subject of a Data Bank report has the right to add a Subject Statement to the report at any time. This does not mean that a healthcare provider can change or correct a report, because the reporting organization and the Secretary of HHS are the only ones who can modify or void a processed report, but it does mean that a healthcare provider can add exculpatory or mitigating information to clarify the issues in dispute and place the disciplinary action in its proper context. Subject statements are reviewed by the Data Bank and may not include identifying patient or other individual confidential information such as names, addresses, or phone numbers. Once processed, the statement becomes part of the report and remains with the report until the healthcare provider edits or removes it. The statement is sent to the reporting organization and all queriers who received a copy of the corresponding Data Bank report in the last 3 years, and it is included in future queries. A subject of a report may modify or remove a Subject Statement at any time.

A report to the Data Bank can significantly impact a healthcare provider’s reputation and career and ultimately affect their ability to work as a healthcare professional in Michigan. As a result, healthcare providers should carefully explore all options such as the filing of a Subject Statement that are available to minimize the professional damage resulting from a Data Bank report and avoid the resulting economic implications. For additional information or assistance, please contact at Jesse Adam Markos, Esq. of Wachler & Associates at (248) 544-0888.

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