[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: 45CFR60.9]



[Page 144-145]

 

                        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.  60.9  Reporting adverse actions on clinical privileges.



    (a) Reporting to the Board of Medical Examiners--(1) Actions that 

must be reported and to whom the report must be made. Each health care 

entity must report to the Board of Medical Examiners in the State in 

which the health care entity is located the following actions:

    (i) Any professional review action that adversely affects the 

clinical privileges of a physician or dentist for a period longer than 

30 days;

    (ii) Acceptance of the surrender of clinical privileges or any 

restriction of such privileges by a physician or dentist--

    (A) While the physician or dentist is under investigation by the 

health care entity relating to possible incompetence or improper 

professional conduct, or

    (B) In return for not conducting such an investigation or 

proceeding; or

    (iii) In the case of a health care entity which is a professional 

society, when it takes a professional review action concerning a 

physician or dentist.

    (2) Voluntary reporting on other health care practitioners. A health 

care entity may report to the Board of Medical Examiners information as 

described in paragraph (a)(3) of this section concerning actions 

described in paragraph (a)(1) in this section with respect to other 

health care practitioners.

    (3) What information must be reported. The health care entity must 

report the following information concerning actions described in 

paragraph (a)(1) of this section with respect to the physician or 

dentist:

    (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) A description of the acts or omissions or other reasons for 

privilege loss, or, if known, for surrender,

    (x) Action taken, date the action was taken, and effective date of 

the action, and

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

time after publication in the Federal Register



[[Page 145]]



and after an opportunity for public comment.

    (b) Reporting by the Board of Medical Examiners to the National 

Practitioner Data Bank. Each Board must report, in accordance with 

Sec. Sec.  60.4 and 60.5, the information reported to it by a health 

care entity and any known instances of a health care entity's failure to 

report information as required under paragraph (a)(1) of this section. 

In addition, each Board must simultaneously report this information to 

the appropriate State licensing board in the State in which the health 

care entity is located, if the Board is not such licensing board.

    (c) Sanctions--(1) Health care entities. If the Secretary has reason 

to believe that a health care entity has substantially failed to report 

information in accordance with Sec.  60.9, the Secretary will conduct an 

investigation. If the investigation shows that the health care entity 

has not complied with Sec.  60.9, the Secretary will provide the entity 

with a written notice describing the noncompliance, giving the health 

care entity an opportunity to correct the noncompliance, and stating 

that the entity may request, within 30 days after receipt of such 

notice, a hearing with respect to the noncompliance. The request for a 

hearing must contain a statement of the material factual issues in 

dispute to demonstrate that there is cause for a hearing. These issues 

must be both substantive and relevant. The hearing will be held in the 

Washington, DC, metropolitan area. The Secretary will deny a hearing if:

    (i) The request for a hearing is untimely,

    (ii) The health care entity does not provide a statement of material 

factual issues in dispute, or

    (iii) The statement of factual issues in dispute is frivolous or 

inconsequential.



In the event that the Secretary denies a hearing, the Secretary will 

send a written denial to the health care entity setting forth the 

reasons for denial. If a hearing is denied, or if as a result of the 

hearing the entity is found to be in noncompliance, the Secretary will 

publish the name of the health care entity in the Federal Register. In 

such case, the immunity protections provided under section 411(a) of the 

Act will not apply to the health care entity for professional review 

activities that occur during the 3-year period beginning 30 days after 

the date of publication of the entity's name in the Federal Register.

    (2) Board of Medical Examiners. If, after notice of noncompliance 

and providing opportunity to correct noncompliance, the Secretary 

determines that a Board has failed to report information in accordance 

with paragraph (b) of this section, the Secretary will designate another 

qualified entity for the reporting of this information.



(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]