Vol. 24 Annals of Health Law 314
data from 9,500 screening procedures. 277 The results from the screenings
revealed that PAs and NPs possess the skills necessary to perform this procedure and thus increase the availability and lower the cost of flexible sigmoidoscopy for colorectal cancer screening. 278
C. PAs – Low Risk, High Reward
The National Practitioner Data Bank (“NPDB”) is a federal data bank
that serves as a repository of all state board actions or malpractice actions
against physicians, dentists, PAs, NPs, and other licensed healthcare professionals. 279 In 1987, the Medicare and Medicaid Patient and Program Protection Act introduced the concept of the NPDB to serve as a repository of information about the health care providers in the United States. 280 The
NPDB was designed to protect Medicare and Medicaid beneficiaries from
incompetent health care providers by restricting the ability of unfit practitioners from moving from state to state. 281 In 1990, the U.S. Department of
Health and Human Services (“HHS”) implemented the NPDB, which requires the “reporting of adverse licensure, hospital privilege, and professional society actions against physicians and dentists related to quality of
care.” 282 In 2007, the Health Resources and Services Administration proposed rules to add other practitioners and PAs to the NPDB. 283
All healthcare practitioners applying for privileges to a hospital or medical center must provide in-depth personal and professional background information that is then submitted to NPDB for clearance. 284 Through this
clearance process, from 1990 through 2008, the NPDB produced information on more than 414,000 reported board actions, malpractice payments,
and Medicare/Medicaid exclusions that involved eighteen different types of
From 1991 to 2007, malpractice payments for all providers exceeded $74
sistants to Perform Screening Flexible Sigmoidoscopy, 13 J. OF THE AM. ACAD. OF NURSE
PRACTITIONERS, 455, 455 (2001).
277. Horton et al., supra note 276, at 457.
278. Horton et al., supra note 276, at 457. (The study here found that the availability of
NAs and PAs in performing flexible sigmoidoscopies resulted in 33 percent lower costs than
if the procedure was performed by a staff gastroenterologist).
279.Na tional Practitioners Data Bank, NCSBN.ORG, available at https://www
. ncsbn.org/418.htm (last visited Nov. 15, 2014); Lisa A. Miller, The National Practitioner
Data Bank: A Primer for Clinicians, 25 J. OF PERINATAL & NEONATAL NURSING 224, 224
280. NCSBN, supra note 302.
281. Miller, supra note 302 at 224.
282. NSCBN, supra note 302.
284. Miller, supra note 302 at 224.
285. Roderick S. Hooker et al., Does the Employment of Physician Assistants and Nurse
Practitioners Increase Liability? 95 J. OF MED. LICENSURE & DISCIPLINE 6, 7 (2009).