The Justice Health Plan is eligible to submit reportable actions against medical practitioners to the National Practitioner Data Bank (NPDB). Justice is considering whether it should report the following actions to the NPDB: Action 1--A medical malpractice insurer made a malpractice payment on behalf of a dentist in Justice's network for a complaint that was settled out of court. Action 2--Justice reprimanded a PCP in its network for failing to follow the health plan's referral procedures. Action 3--Justice suspended a physician's clinical privileges throughout the Justice network because the physician's conduct adversely affected the welfare of a patient. Action 4--Justice censured a physician for advertising practices that were not aligned with Justice's marketing philosophy. Of these actions, the ones that Justice most likely must report to the NPDB include Actions
A) 1, 2, and 3 only
B) 1 and 3 only
C) 2 and 4 only
D) 3 and 4 only

Question

Quizplus · Accepted Answer

Action 1 involves a malpractice payment, which is a reportable offense by healthcare providers. Action 2 is a reprimand for not following referral procedures, which is not a reportable offense. Action 3 involves suspension of clinical privileges due to patient harm, which is reportable. Action 4 involves a censure for advertising practices, which is not a reportable offense. Therefore, Justice should report Actions 1 and 3 to the NPDB.

The Justice Health Plan Is Eligible to Submit Reportable Actions