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A health care entity terminated a physician’s contract for causes relating to poor patient care, which in turn resulted in the loss of the practitioner’s network participation. Should this be reported to the NPDB using one or two reports?
Depending on the circumstances, the health care entity may be required to submit two different reports. The loss of the practitioner’s network participation that resulted from the termination of the contract for reasons relating to professional competence or professional conduct must be reported as a clinical privileges action only if it is considered to be a professional review action by the health care entity.
The termination of the practitioner’s contract with the health care entity, in itself, does not meet NPDB reporting criteria for a clinical privileges action. However, if the contract termination meets the requirements of an “other adjudicated action or decision,” the contract termination should be reported separately to the NPDB.