Tag Archives: NPDB

Journalism organizations ask HRSA to clarify how it will exercise restrictions

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The Association of Health Care Journalists and five other journalism organizations asked federal health officials this week to specify how they plan to enforce new rules governing access to the public version of the National Practitioner Data Bank.

In a letter to Mary Wakefield, administrator of the Health Resources and Services Administration, the groups continued to express disappointment in the agency’s restrictions on the data bank’s Public Use File. In the past, reporters have used the file to expose faulty oversight of doctors by state medical boards.

The Health Resources and Services Administration removed the public file from its website in September after a complaint from a doctor who complained information on him was used inappropriately. The agency republished the data last month but put in place restrictions on how the data could be used.

Among the restrictions is a provision that bars users from matching data in the Public Use File with other data sources to identify physicians. If journalists or others are found to have violated the provision, they could be required to return the data and be barred from receiving it in the future.

In the letter to Wakefield, sent Wednesday, the groups asked for answers to several questions:

  1. What process will HRSA follow to determine whether a reporter has violated the agreement? If a reporter identifies a doctor in a story and also had access to the Public Use File, how will the agency find out whether the reporter used the file to identify the doctor or got the information from another source? Will HRSA ask to see notes and talk to sources? What will the agency do if reporters decline to discuss their reporting methods beyond what appears in their stories?
  2. What recourse will reporters have if they believe they have been unfairly barred from future access to the file?
  3. If you ask a reporter to return data, will you take any steps to ensure the data hasn’t been copied or saved elsewhere? If so, what will those steps be?
  4. How will HRSA address stories written based on copies of the Public Use File downloaded before Sept. 1? Such files are available without restriction on the websites of journalism organizations, and reporters do not need to sign any agreement to access them. Will reporters face penalties if they use the information in a way that HRSA objects to?

AHCJ president Charles Ornstein said he continues to believe that the new restrictions are both ill-advised and likely unconstitutional. But he added, “If HRSA intends to stick to them, it’s imperative that journalists understand how they will be enforced before deciding whether to use this information.”

Other groups signing the letter were Investigative Reporters and Editors, the Society of Professional Journalists, the National Association of Science Writers, the Reporters Committee for Freedom of the Press and the National Freedom of Information Coalition.

Investigative Reporters and Editors, working with AHCJ and the Society of Professional Journalists, has posted the data for download, free to the public.

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

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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.

Secrecy around data bank protects ‘Practitioner No. 222117’

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Alan Bavley of The Kansas City Star provides us with a stark illustration of why new restrictions on the use of the National Practitioner Data Bank are not in the public interest.

In the most straightforward example yet, Bavley reports on “Practitioner No. 222117,” a doctor whose medical licenses have been revoked or suspended by 20 states, who was banned from billing Medicaid or Medicare and whose license to prescribe was yanked by the Drug Enforcement Administration. Bavley learned all of that from perusing the data bank’s Public Use File.

The NPDB includes reports on malpractice payments and disciplinary actions involving health care professionals. Hospitals and state medical boards can use the data when deciding to grant staff privileges or when reviewing license applications, though AHCJ found state medical boards do that less than you might expect. The NPDB’s Public Use File, available for download on a public website, removes identifying information. Bavely’s article explains more about how they de-identify the data.

Despite all we know about Practitioner No. 222117, we don’t know if he or she is still practicing medicine. The public, including journalists, is restricted from using the data to identify this doctor.

In the past, reporters have used information in the Public Use File, in combination with other records, to identify to flesh out their reporting on troubled doctors and show the failure of medical boards to act against doctors with multiple malpractice awards.

That ended on Sept. 1, when the U.S. Health Resources and Services Administration, which runs the database, removed the public use file because one doctor complained about stories that Bavley was writing.

AHCJ, along with other journalism groups and patient-safety advocates, decried the database’s removal. In November, HRSA restored the Public Use File – but with restrictions on how it can be used. Reporters and researchers have to agree not to connect any individual to information in the database. Reporters can be barred from future access to the database if HRSA decides they have violated the rules. For more background, please see AHCJ’s Right to Know page or this timeline.

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.

Numbers reveal how often, or how rarely, states check doctors’ disciplinary records

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How often does your state medical board search doctors in the National Practitioner Data Bank?

Surprisingly not often, according to data provided to the Association of Health Care Journalists by the U.S. Health Resources and Services Administration, which runs the data bank.

Get a spreadsheet showing how often each state medical board searches for doctors in the National Practitioner Data Bank. One worksheet shows information about physicians, the other shows information about residents and interns.

AHCJ and other media groups have been pushing the government to restore unfettered access to the Public Use File of the data bank, citing important stories that journalists have written about lax oversight of doctors by state medical boards.

State medical boards have access to complete information within the data bank about a doctor’s disciplinary history, hospital sanctions and malpractice payouts. The Public Use File, which had been available to reporters and researchers for years, provided the same information without identifying information about the doctors involved.

HRSA removed  the Public Use File from its website on Sept. 1 following complaints from a doctor that a reporter from The Kansas City Star inappropriately used it to identify him. The agency restored the file last week, but with new restrictions that seek to bar reporters from using it with other data sets to identify physicians. AHCJ and other media groups call the new restrictions unworkable and an unconstitutional prior restraint.

AHCJ requested data from HRSA so reporters could see how often their states check the backgrounds of MDs and DOs, as well as interns and residents. The numbers are available in two different charts. Beyond that, HRSA said, three state boards have a relationship with HRSA in which they automatically get updates when new information is entered on a physician. They are: Nevada (DO), Oregon (MD) and Pennsylvania (MD).

“I encourage journalists to look up their state medical boards in our chart and see how often they consult the data bank,” AHCJ President Charles Ornstein said. “If they are not looking physicians up, they should be asked how they are sure they are protecting the public from dangerous or incompetent doctors.”

HRSA spokesman Martin Kramer said in an email that,

HRSA is also working proactively to protect the public by reducing potential barriers for State licensing boards to receive NPDB information.

One step that HRSA took in the past year was to conduct a small pilot study with the Federation of State Medical Boards to determine if hospitals and medical malpractice payers send a copy of  the NPDB report, as required, to the licensing board.

To assure that Medical Boards receive the hospital and medical malpractice payment reports, in January 2012 the reporters (hospitals and medical malpractice payers) will be able to send an electronic copy to the State medical board through the NPDB.

We believe this change will be cost saving and time effective for the reporters and State medical boards.”

For more background, this timeline tracks the story:

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.

Agency’s restrictions on data about disciplined doctors continue to get attention

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The Kansas City Star and The Sacramento Bee ran editorials over the weekend to denounce the recent decision by the U.S. Health Resources and Services Administration to place restrictions on the public use file of the National Practitioner Data Bank.

The Star says the restrictions “display an appalling disrespect for journalists and researchers and for the public’s right to gain information about the doctors to whom they entrust their health and safety.”

It calls the move a “clumsy attempt to restrict access to public information [that] promotes nothing but confusion and darkness.”

Meanwhile, The Bee says the Obama administration has “positioned itself on the side of protecting the privacy of doctors who maim patients.” It also suggests that President Obama reread the First Amendment.

On Sunday, the Society of Professional Journalists hosted AHCJ President Charles Ornstein, SPJ President John Ensslin and Kansas City Star reporter Alan Bavley for a discussion of the data bank and the importance of its information being open to the public without restrictions.

As regular Covering Health readers know, the public use file has been used regularly by reporters who have covered lax oversight of troubled doctors. When Bavley was working on such a story, however, a doctor he was investigating contacted HRSA and complained the data was being used improperly. That doctor’s complaints led to HRSA threatening Bavley with a fine, which it later backed down from, and pulling the data off of the website.

After protests from journalism organizations, consumer groups, academic researchers and U.S. Sen. Charles Grassley, the agency republished the data file last Wednesday but placed restrictions on how it was to be used. In a letter to U.S. Health and Human Services Secretary Kathleen Sebelius, the journalism groups called the new restrictions “ill-advised, unenforceable and probably unconstitutional. Restricting how reporters use public data is an attempt at prior restraint.”

Grassley also has expressed his disappointment in the restrictions: “HRSA is overreaching and interpreting the law in a way that restricts the use of the information much more than the law specifies.”

For more background, this timeline tracks the story:

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.

Journalism groups protest HRSA restrictions to Sebelius

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The Association of Health Care Journalists and six other journalism organizations on Thursday formally protested the Obama administration’s new restrictions on access to the republished Public Use File of the National Practitioner Data Bank.npdb-sebelius-letter-image

In a letter to U.S. Health and Human Services Secretary Kathleen Sebelius, the groups said that the new restrictions “are ill-advised, unenforceable and probably unconstitutional. Restricting how reporters use public data is an attempt at prior restraint.”

The Health Resources and Services Administration removed the Public Use File of the data bank from its website in September after a complaint from a doctor who complained information on him was used inappropriately. The agency republished the data on Wednesday but put in place restrictions on how the data could be used.

Among the restrictions is a provision that bars users from matching data in the Public Use File with other data sources to identify physicians. If journalists or others are found to have violated the provision, they could be required to return the data and be barred from receiving it in the future.

An excerpt from the letter:

This puts journalists in an untenable position. How can reporters who use the file prove that their identification of a troubled doctor was independent of the Public Use File? If reporters identify doctors in their stories and also have had access to the file, would HRSA ask to see their notes, talk to their sources, confirm that their facts came from other records and not the data bank?

In addition to AHCJ, the letter is signed by the Investigative Reporters and Editors, the Society of Professional Journalists, the National Association of Science Writers, the Reporters Committee for Freedom of the Press, the National Freedom of Information Coalition and the National Conference of Editorial Writers.

The editorial writers group has recently joined the coalition of media organizations seeking a return of the Public Use File as it was available before September – without restrictions.

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.