Michigan Decides to Report Failures to Obtain the Required Continuing Education to the National Practitioner Data Bank

Revisions to the National Practitioner Data Bank (the “Data Bank”) and the Michigan Department of Licensing and Regulatory Affairs’ (“LARA”) subsequent interpretation of those revisions has made it difficult to prevent any licensure action from becoming part of a provider’s “permanent record.” This includes the failure to complete continuing education requirements. In response, health care providers must remain vigilant in completing these requirements and providing timely and sufficient documentation of their completion.

The Data Bank was established by the Health Care Quality Improvement Act of 1986, and contains reports of adverse licensure, clinical privileges, professional society membership, DEA, HHS, OIG actions and medical malpractice payments made against health care providers. Hospitals, health care entities that conduct peer review activities, professional societies that conduct peer review, and state licensing boards can query the Data Bank for information on a provider, usually for employment, credentialing or licensure purposes.

In 2010, regulations authorized by section 1921 of the Social Security Act made important changes to the Data Bank. One such change required states to report any negative action or finding that a state has finalized against a health care provider. A negative action or finding is any action taken by the state licensure board that is publicly available information, excluding administrative fines or citations and corrective action plans unless they are connected to the delivery of health care services or assessed along with other reportable action. In other words, a reportable administrative fine is one that is considered administrative or technical in nature and is reportable if it is related to health care delivery.

The Data Bank provides state licensing authorities with discretion to determine whether or not administrative fines resulting from the failure to obtain the required continuing education units (CEUs) is a negative action or finding related to the delivery of health care. According to guidance provided by the Data Bank, if a State considers the failure of a provider to obtain the required CEUs as a negative action or finding related to the delivery of health care and the board imposes a fine, then such action is reportable to the Data Bank. The Data Bank further provides that another State may consider the imposition of a fine for failing to meet mandatory CEUs as administrative, not relating to the delivery of health care. In that case the action is not reportable.

Experience confirms that Michigan’s LARA considers monetary fines for the failure to complete CEU requirements or the failure to provide timely and sufficient documentation of their completion to be related to health care delivery and reportable to the Data Bank. Therefore, it is important for health care providers to be vigilant in completing CEU requirements and providing sufficient documentation of their completion in a timely manner. Due to Michigan’s decision to consider the failure to comply with CEU requirements to be a negative action related to the delivery of health care, the failure to do so will be reportable to the Data Bank and thus on the provider’s record for the rest of his or her career. As a result, health care providers should carefully and prevent a Data Bank report and avoid the resulting professional damage and economic implications. For additional information or assistance, contact a Wachler & Associates attorney at (248) 544-0888.