[Code of Federal Regulations]

[Title 45, Volume 1]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 45CFR60.7]



[Page 142-143]

 

                        TITLE 45--PUBLIC WELFARE

 

                    SUBTITLE A--DEPARTMENT OF HEALTH

                           AND HUMAN SERVICES

 

PART 60_NATIONAL PRACTITIONER DATA BANK FOR ADVERSE INFORMATION ON 

PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS--Table of Contents

 

                   Subpart B_Reporting of Information

 

Sec.  60.7  Reporting medical malpractice payments.



    (a) Who must report. Each entity, including an insurance company, 

which makes a payment under an insurance policy, self-insurance, or 

otherwise, for the benefit of a physician, dentist or



[[Page 143]]



other health care practitioner in settlement of or in satisfaction in 

whole or in part of a claim or a judgment against such physician, 

dentist, or other health care practitioner for medical malpractice, must 

report information as set forth in paragraph (b) to the Data Bank and to 

the appropriate State licensing board(s) in the State in which the act 

or omission upon which the medical malpractice claim was based. For 

purposes of this section, the waiver of an outstanding debt is not 

construed as a ``payment'' and is not required to be reported.

    (b) What information must be reported. Entities described in 

paragraph (a) must report the following information:

    (1) With respect to the physician, dentist or other health care 

practitioner for whose benefit the payment is made--

    (i) Name,

    (ii) Work address,

    (iii) Home address, if known,

    (iv) Social Security number, if known, and if obtained in accordance 

with section 7 of the Privacy Act of 1974,

    (v) Date of birth,

    (vi) Name of each professional school attended and year of 

graduation,

    (vii) For each professional license: the license number, the field 

of licensure, and the name of the State or Territory in which the 

license is held,

    (viii) Drug Enforcement Administration registration number, if 

known,

    (ix) Name of each hospital with which he or she is affiliated, if 

known;

    (2) With respect to the reporting entity--

    (i) Name and address of the entity making the payment,

    (ii) Name, title, and telephone number of the responsible official 

submitting the report on behalf of the entity, and

    (iii) Relationship of the reporting entity of the physician, 

dentists, or other health care practitioner for whose benefit the 

payment is made;

    (3) With respect to the judgment or settlement resulting in the 

payment--

    (i) Where an action or claim has been filed with an adjudicative 

body, identification of the adjudicative body and the case number,

    (ii) Date or dates on which the act(s) or omission(s) which gave 

rise to the action or claim occurred,

    (iii) Date of judgment or settlement,

    (iv) Amount paid, date of payment, and whether payment is for a 

judgment or a settlement,

    (v) Description and amount of judgment or settlement and any 

conditions attached thereto, including terms of payment,

    (vi) A description of the acts or omissions and injuries or 

illnesses upon which the action or claim was based,

    (vii) Classification of the acts or omissions in accordance with a 

reporting code adopted by the Secretary, and

    (viii) Other information as required by the Secretary from time to 

time after publication in the Federal Register and after an opportunity 

for public comment.

    (c) Sanctions. Any entity that fails to report information on a 

payment required to be reported under this section is subject to a civil 

money penalty of up to $10,000 for each such payment involved. This 

penalty will be imposed pursuant to procedures at 42 CFR part 1003.

    (d) Interpretation of information. A payment in settlement of a 

medical malpractice action or claim shall not be construed as creating a 

presumption that medical malpractice has occurred.



(Approved by the Office of Management and Budget under control number 

0915-0126)



[54 FR 42730, Oct. 17, 1989, as amended at 59 FR 61555, Dec. 1, 1994]