Under the Illinois Medical Practice Act (the “MPA”), a physician is obligated to report a settlement or judgment in a medical malpractice action to the Illinois Department of Financial and Professional Regulation (the “IDFPR”).  The MPA also requires insurance carriers to report the same.  After receiving a report from an insurance carrier, the IDFPR will notify a physician of the report and request detailed information regarding the claim and treatment.  From this information, the IDFPR will decide whether to pursue disciplinary action against the physician.  Generally, a physician’s malpractice attorney will not guide him or her through the process of an IDFPR investigation.  It is critical the physician contact his or her own attorney, who is specialized in actions before the IDFPR Board.

      The National Practitioner Databank (“NPDB”) was established by the Health Care Quality Improvement Act of 1986 (the “Act”).  Under the Act, an entity or insurance company that makes a payment of a settlement or judgment on behalf of a physician for a professional malpractice claim must report the payment to the NPDB and to the appropriate state licensing board(s).  A report to the NPDB can have significant repercussions and should not be taken lightly.  It may impact a decision on a physician’s staff privileges or employment relationship.  As state licensing board(s) have access to the NPDB, a report made to the NPDB may also impact potential licensure decisions and could trigger an IDFPR investigation.  Although it is recognized that lawsuits are often settled for reasons other than the negligence of a practitioner, the requirement that all settlements or payments of judgment must be reported to the NPDB flags a practitioner for further scrutiny.  When considering whether to settle a matter or proceed to trial, a practitioner should consider how a potential report to the NPDB could impact professional and employment relationships, as well as licensure.  The Firm can assist providers in actions before both the IDFPR and NPDB.  Our attorneys are nationally recognized for their representation of physicians related to licensing and credentialing issues.  Please contact us if you require assistance.