Risk Management and Medical Liability
A Manual for Indian Health Service and Tribal Health Care Professionals
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Section Thirteen: State Licensing Boards and the
Federation of State Medical Boards
State Licensing Board
All Indian Health Service (IHS) physicians who have patient care responsibilities are required to maintain a valid and unrestricted state license. Medical malpractice payers (including the IHS) must report medical malpractice payments simultaneously to the National Practitioner Data Bank and the appropriate state licensing board authority. Each health care entity must also report to the respective state board of medical examiners the following actions:
- Any professional review action that adversely affects the clinical privileges of a physician or dentist for a period longer than 30 days
- Acceptance of the surrender of clinical privileges or any restriction of such privileges by a physician or dentist
- While the physician or dentist is under investigation by the health care entity relating to possible incompetence or improper professional conduct, or
- In return for not conduction such an investigation or proceeding
- In the case of a health care entity that is a professional society, when it takes a professional review action.
Whether or not any action is taken against a physician’s license who has been involved in a malpractice action depends on the severity of negligence and number of incidents. In general most tort claims or suits involving federal employees do not result in any license restrictions or suspensions. However, the state licensing board may wish to perform its own review of the incident and will seek discovery of the medical records involved. Federal Privacy Act statutes prevent the disclosure of medical records directly to state regulatory boards. State boards who wish to receive copies of IHS-controlled medical records must file a Freedom of Information Act Request (FOIA) with the Agency’s FOIA Officer.1 Once the FOIA request has been approved, the FOIA Officer is responsible for de-identifying the records prior to releasing them to the state board. Health care providers should never release such records on their own, even if they are issued a state court subpoena. All requests for medical records received at the local facility from outside agencies should be referred to the facility’s administration for proper processing.
The Federation of State Medical Board
The Federation of State Medical Boards (FSMB) serves as the primary center for collection, maintenance, and reporting of disciplinary actions taken against physicians by its member boards and other governmental authorities. Disciplinary actions are reported to the FSMB by state licensing and disciplinary boards, Canadian licensing authorities, the U.S. armed forces, the U.S. Department of Health and Human Services, and the Education Commission for Foreign Medical Graduates.
FSMB’s membership is comprised of the medical boards of all states, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands, and includes 11 of the 16 separate osteopathic boards in the United States. The ten Canadian provincial medical licensing authorities hold affiliate membership. The Federation is a parent and member organization of the National Board of Medical Examiners, the Accreditation Council for Continuing Medical Education, and the American Board of Medical Specialists.
Actions included in the FSMB Data Bank are revocations, probations, suspensions, and other regulatory actions such as license denials and reinstatements. Medicare sanctions and Department of Defense adverse privileging actions are also included in the FSMB Bank. Information on medical malpractice payments is not stored in this database.
1 See section XVIII, Selected Resources, for address and telephone number of FOIA Officer.
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