Credentialing & Privileging

NPDB Fee Waiver Helps America’s Healthcare System Mobilize Health Professionals During the COVID-19 Pandemic

By Donald Illich and Derek Wilkinson

With the emergence of the COVID-19 pandemic and emergency declarations at the national, state, and local levels, the Health Resources and Services Administration (HRSA) temporarily waived fees for continuous and one-time National Practitioner Data Bank (NPDB) queries. This temporary query fee waiver provided healthcare entities and medical professionals another tool to quickly mobilize and deploy quality healthcare professionals to combat the COVID-19 pandemic in areas where they were needed. During this unprecedented time, healthcare entities relied on the NPDB to make informed hiring, licensing, and credentialing decisions, while maintaining appropriate standards for the nation's healthcare workforce.

HRSA recognized the need to support entities in establishing the infrastructure necessary to maximize the portability of the nation's health workforce. Between March 1, 2020, and Sept. 30, 2020, HRSA waived query fees to support eligible healthcare entities in making credentialing, hiring, privileging, and licensing decisions to respond to the COVID-19 pandemic. Because the waiver was announced retroactively, the NPDB issued query credits to entities that were charged fees for one-time queries, continuous queries, and continuous query renewals during the waiver period. Query credits do not expire.

Querying requirements remained the same during the fee waiver. Under federal law, hospitals must query when:

• An individual applies for staff appointment or clinical privileges, and
• Every two years on medical staff members and clinical privileges holders

Other entities may query only on individuals with whom there is an existing relationship:

• Employment or affiliation relationship (current or pending), or
• Application for clinical privileges (including temporary privileges) or medical staff appointment

State licensing boards and certain other federal, state, and local agencies may query the NPDB to determine the fitness of individuals to provide healthcare services, protect the health and safety of individuals receiving healthcare services, and prevent healthcare fraud.

Information reported to the NPDB is considered confidential and must be used solely for the purpose for which it was provided.

For questions concerning the current status of NPDB querying recommendations or mandates by accrediting bodies, such as the Joint Commission, National Committee for Quality Assurance (NCQA), URAC, or DNV GL, we recommend contacting the accrediting organization directly.

Results: NPDB Usage During the Fee Waiver Period

Between March 1 and Sept. 30, 2020, over 6 million free NPDB queries were processed for health systems in every state of the nation, saving healthcare entities over $12M. The NPDB processed over 1 million queries in one month for the first time since its implementation in 1990 (May 2020). On Sept. 30, 2020, the NPDB processed 155,964 queries, which is the highest record number of queries processed in a single day in the past five years. Hospitals, health plans, and licensing boards accounted for 83% of all queries. The query volume from March through September 2020:

• Represents a 7% increase in overall query volume from the same period in 2019
• Hospital querying represents a 15% increase in query volume from the same period in 2019

The NPDB is entirely self-funded, generated from user queries. To maintain operations, the NPDB resumed charging for all queries beginning Oct. 1, 2020. There is a $2 charge for every query of a practitioner, entity, provider, or supplier. Self-queries, from individuals or organizations, cost $4.

The NPDB appreciates several organizations that helped in announcing the query fee waiver, including National Association Medical Staff Services, the American Hospital Association, Federation of State Medical Boards, National Council of State Boards of Nursing, and Council on Licensure, Enforcement, and Regulation, to name a few. We’re honored to have played a role in helping our entities during this pandemic.

For more information, visit the NPDB Web site at www.npdb.hrsa.gov. For questions about querying or any other questions, contact the Customer Service Center at help@npdb.hrsa.gov or 1-800-767-6732. The hours of operation for the NPDB Customer Service Center are Monday–Thursday 8:30 a.m. to 6:00 p.m. and Friday 8:30 a.m. to 5:30 p.m. EST. The Customer Service Center is closed on weekends and federal holidays. For infographics on querying, visit https://www.npdb.hrsa.gov/hcorg/aboutQuerying.jsp.