National Credentialing Forum February 5, 2015

Ivy Vedamuthu U.S. Department of Health and Human Services Health Resources and Services Administration National Practitioner Data Bank

Presentation Overview

• • • • • • • • Purpose Fee Changes System Enhancements Research Survey Compliance 2015 Educational Forum Resources Contact Information 2

Purpose

Created under three statutes to meet several needs

• Flagging system for effective credential reviews • Protection against unfit practitioners • Deter fraud and abuse in the health care system

Fee Changes

Fee Structure Changes One Time $4.75 $3.00

Continuous $3.25 Self Query $8.00

$3.00

$5.00

In October 2014, users of the NPDB saved $784,000.00

System Enhancements

System Enhancements

Benefits of Moving to the Cloud •

Cost Savings

: Implementing the first HRSA system to move to a cloud data center will save a significant amount of money in maintenance costs each year •

Scalability

: Faster and easier adjustment to ebb and flows of use •

Faster on-screen response time

: The screens load faster and the system is more responsive

System Enhancements

Field of Licensure Updates and Report Input Changes • Some occupation titles were retired or merged, and replaced with more accurate titles • Users may now specify an "Other Name for Occupation” in more cases

System Enhancements

QRXS Submission Duplication Checking Many large entities use the Querying and Reporting XML Software (QRXS) to submit high-volume batch queries and reports. Occasionally, users will inadvertently submit duplicate transactions, resulting in errors or duplicate charges. New automated checks have been added to help detect and limit accidental duplicate transactions.

System Enhancements

• • Upcoming Changes Re-designing the user screens for self-query, one-time query and continuous query to make them more intuitive and require fewer steps/clicks.

Enhancements to come in April and May of 2015

Research Survey

Research Survey

• Comprehensive Survey of NPDB Eligible Users 13 years since last survey • Survey response rate of 68% for organizations • Findings reveal: • • • user satisfaction with NPDB technology user perceptions of information impact of information on hiring, credentialing, licensing, or granting clinical privileges to health care practitioners.

• Findings will be used to improve user experience

Compliance

Compliance State Board Adverse Action Comparison Impact

(As of Oct. 2014) Data Bank compliance efforts over past 2 years: • • • Reviewed 2,154 health professions in 50 states, DC, and 5 territories (96% compliant) 6,505 previously missing reports submitted by entities 868 of those reports disclosed a total of 2,682 times

Compliance Approximate Number of New Data Bank Reports Submitted (Practitioners Only) From 2010 – 2013 by Profession

Registered Nurses 109 000 Licensed Practical/ Vocational Nurses 70,000 Advanced Practice Nurses 3,000 Physician Assistants 3,000 Dentists 15 000 Physicians 78 000 Nurse Aides/ Nursing Assistants 39,000

Total: ~403,000 Practitioner Reports

Social Workers 3 000 Pharmacists/ Pharmacy Technicians 22,000 Other 54 000 Physical/Occupational Therapists/Assistants 5 000 Respiratory Therapists 2,000

2015 Educational Forum

2015 Educational Forum

When:

April 7, 2015

Where:

DC Area

How:

In-person only 16

2015 Educational Forum

There are five areas of focus for attendees • Reporting to the National Practitioner Data Bank (NPDB) • Interpreting a Query Response • Leveraging the NPDB’s Online Research Applications • System Updates • The New NPDB Guidebook

2015 Educational Forum

The NPDB has created a series of four instructional videos • Data Bank Customer Support Resource Series: Research Applications • Data Bank Customer Support Resource Series: Reporting Adverse Licensure Actions • Data Bank Customer Support Resource Series: Reporting Clinical Privileges Actions • Data Bank Customer Support Resource Series: Reporting Medical Malpractice Payments

Resources

Web Site – – – – – – www.npdb.hrsa.gov

NPDB Guidebook Interactive Training FAQs, Brochures, and Fact Sheets Statistics Instructions for Reporting and Querying

Customer Service Center

800-767-6732 or 800-SOS-NPDB [email protected]

NPDB Compliance Tip Line 301-945-9601

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The Health Insurance Marketplace

The next open enrollment period is November 15, 2014- February 15, 2015

www.healthcare.gov

Contact Information

Ivy Vedamuthu Disputes Team Lead Policy and Disputes Branch Division of Practitioner Data Bank Bureau of Health Workforce Health Resources and Services Administration U.S. Department of Health and Human Services Telephone: 301-443-9738 Email: [email protected]

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