HHS responds to questions about enforcement of NPDB restrictions

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Journalists who name troubled physicians in their stories after downloading a public version of the National Practitioner Data Bank do not have to answer government questions about their sources and will not be subject to criminal, civil or administrative penalties if they violate new restrictions on use of the database.npdb-041312

That’s according to a spokesman for the U.S. Department of Health and Human Services, who wrote to AHCJ last week. AHCJ had asked the U.S. Health Resources and Services Administration, which operates the database, how it intended to enforce the new restrictions on its use, which were imposed late last year.

The federal response is the latest in a long-running dispute between the Obama administration and journalism organizations about the Public Use File of the government’s doctor disciplinary database.

The National Practitioner Data Bank compiles malpractice payouts, hospital discipline and regulatory sanctions against medical practitioners, for private use by hospitals and other organizations that credential them.

While the data bank is secret, for years HRSA has posted a Public Use File, often consulted by reporters and researchers. This public version of the data bank lists the disciplinary actions, but identifies the doctors and other practitioners only by number. As required by law, it contains no identifying information, such as names, addresses, Social Security numbers or dates of birth. But reporters have used the Public Use File to enhance information they had gathered elsewhere on known doctors.

HRSA removed the Public Use File from its website last year for two months after a doctor and his lawyer complained that a Kansas City Star reporter improperly used it to identify him. Following protests from journalists and consumer groups, in November, HRSA restored the public file but began requiring anyone wishing to download it to agree he or she will not use it to identify individual physicians.

The Association of Health Care Journalists, Investigative Reporters and Editors, National Association of Science Writers, National Freedom of Information Coalition, Reporters Committee on Freedom of the Press, and Society of Professional Journalists protested this decision.

In a letter sent to HRSA administrator Mary Wakefield in December, the groups asked what process HRSA would follow to determine whether a reporter had violated the agreement and whether HRSA would ask to see notes and talk to sources, among other questions.

In a response, HHS Deputy Assistant Secretary for Public Affairs Chris Stenrud wrote:

“As you know, HRSA is required by law to maintain the information in the Public Use File of the National Practitioner Data Bank (NPDB) in a form that does not permit the identification of individual practitioners or health care entities. The data use agreement (DUA) was added to help ensure that the data would be in such a form and HRSA’s legal obligation under the statute would be met.

“HRSA will investigate alleged breaches of the DUA on a case-by-case basis. HRSA may request additional information from the reporter or third parties, but the Department cannot compel reporters or third parties to speak with us. We have been advised by the HHS Office of the General Counsel that a user who violates the Public Use File’s DUA is not subject to criminal, civil or administrative penalties. If HRSA determines that data from the PUF have been misused, however, HRSA would need to re-examine the data and consider removal of any specific data points that are making the information identifiable.”

AHCJ President Charles Ornstein said he believes the government continues to misinterpret the law governing the database, noting that previous Democratic and Republican administrations had not imposed this requirement on the same information. That said, he advised reporters using the Public Use File to exercise their rights not to answer questions about their reporting methods that federal officials may ask.

“This fight is not over,” Ornstein said. “While we are adamant that the government return free and open access to this database, this letter provides answers to some of the questions we asked,” Ornstein said. “In the event the government comes calling, reporters do not have to answer questions about their sources, and they and their organizations cannot be penalized in any way for their use of the Public Use File.”

Ornstein suggested reporters speak to their editors and attorneys before downloading the database. Another option, he said, is for concerned reporters to download a slightly older version of the file -which has no restrictions on its use – from the website of the Investigative Reporters and Editors. The file has not been updated since August 2011.

“If anyone encounters any difficulty or problems from government officials regarding their use of the doctor discipline database, please alert us immediately,” Ornstein said.

For more background, please see AHCJ’s Right to Know page or this timeline.

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