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HHS Clarifies NPDB Reporting Obligations

Client Alert | 1 min read | 09.24.03

Some health care entities have expressed concern that the National Practitioner Data Bank regulations require health care entities to report adverse actions taken against practitioners to both the NPDB and the applicable State Board of Medical Examiners, while the NPDB Guidebook directs health care entities to report directly to the NPDB first, and then subsequently to send to the State Board the Report Verification Document that the NPDB sends to the plan confirming receipt of the adverse action report in satisfaction of the plan's Board reporting obligation. We requested confirmation of health care entity obligations from the NPDB, and received the attached letter from HRSA Deputy Administrator Cynthia Grubbs in response. The letter confirms the process set forth in the Guidebook, and should provide additional comfort to health care entities who may have been unsure of their obligations.

Insights

Client Alert | 8 min read | 04.17.26

CMS Finalizes CY 2027 Medicare Advantage and Part D Rule: Key Implications for Plan Sponsors

On April 6, 2026, the Centers for Medicare & Medicaid Services (CMS) published its final rule governing the Medicare Advantage (Part C) and Prescription Drug Benefit (Part D) programs for Contract Year (CY) 2027. The final rule is effective June 1, 2026, with most provisions applicable to coverage beginning January 1, 2027, and marketing and communications changes taking effect October 1, 2026. Beyond payment, the rule pursues a broad deregulatory agenda aligned with Executive Order 14192, reversing marketing and enrollment safeguards introduced in 2023 and easing documentation and reporting obligations, while introducing new program integrity requirements....