Federal Register / Vol. 66, No. 108 / Tuesday, June 5, 2001 / Proposed Rules 30141

amendment provisions of subsection

(d), pursuant to subsection (k)(2) of the

Privacy Act.

§ 1202.94 What NARA systems of records

are exempt from release under the

Investigatory Information Material

exemption of the Privacy Act?

(a) The General Law Files (NARA–18)

and the Personnel Security Case Files

(NARA–24) systems of records are

eligible for exemption under 5 U.S.C.

552a(k)(5) because these contain

investigatory material compiled solely

for the purpose of determining

suitability, eligibility, or qualifications

for federal employment or access to

classified information. The only

information exempt under this

provision is that which would disclose

the identity of a confidential source

described in 5 U.S.C. 552a(k)(2).

(b) The systems of records described

in paragraph (a) of this section are

exempt from 5 U.S.C. 552a(d)(1).

Exemption from the particular

subsection is justified as access to

records in the system would reveal the

identity(ies) of the source(s) of

information collected in the course of a

background investigation.

Dated: May 29, 2001.

John W. Carlin,

Archivist of the United States.

[FR Doc. 01–14077 Filed 6–4–01; 8:45 am]

BILLING CODE 7515–01–P

DEPARTMENT OF VETERANS

AFFAIRS

38 CFR Part 46

RIN 2900–AJ76

Policy Regarding Participation in

National Practitioner Data Bank

AGENCY: Department of Veterans Affairs.

ACTION: Proposed rule.

SUMMARY: We propose to amend our

regulations regarding reporting of health

care practitioners to the National

Practitioner Data Bank (NPDB). We

propose to amend the reporting

provisions concerning malpractice

payment reporting by delegating the

underlying decision-making to

malpractice payment review panels; by

delegating the actual reporting authority

to facility directors and the Chief Patient

Care Services Officer; by establishing

new procedures for obtaining

information from affected health care

practitioners and others; and by

establishing medical reporting criteria

for licensed trainees and supervisory

health care professionals. We also

propose to amend the regulations

concerning malpractice payment

reporting and clinical privileges actions

reporting by stating that reporting may

not be the subject of negotiated

settlements and that independent

contractors acting on behalf of the

Department of Veterans Affairs (VA) are

subject to the NPDB reporting

provisions. These amendments appear

to be necessary to make the reporting

process more efficient and fair and to

ensure that reporting is accomplished in

accordance with the statutory

framework.

DATES: Comments must be received on

or before August 6, 2001.

ADDRESSES: Mail or hand-deliver

written comments to: Director, Office of

Regulations Management (02D),

Department of Veterans Affairs, 810

Vermont Ave., NW., Room 1154,

Washington, DC 20420; or fax comments

to (202) 273–9289; or e-mail comments

to OGCRegulations@mail.va.gov.

Comments should indicate that they are

submitted in response to ‘‘RIN: 2900–

AJ76.’’ All written comments received

will be available for public inspection at

the above address in the Office of

Regulations Management, Room 1158,

between the hours of 8 a.m. and 4:30

p.m., Monday through Friday (except

holidays).

FOR FURTHER INFORMATION CONTACT:

Kathryn W. Enchelmayer, Director,

Credentialing and Privileging, Office of

Quality and Performance (10Q), VHA,

Department of Veterans Affairs, 810

Vermont Avenue, NW., Washington, DC

20420; (301) 443–9901 (This is not a

toll-free number).

SUPPLEMENTARY INFORMATION: This

document proposes to amend our

regulations set forth in 38 CFR Part 46

concerning the reporting of physicians,

dentists, and other health care

practitioners to the NPDB. These

regulations concern malpractice

payment reporting and clinical

privileges actions reporting.

With respect to malpractice payment

reporting, the regulations currently

provide that VA will file a report with

the NPDB regarding any payment for the

benefit of a physician, dentist, or other

health care practitioner which was

made as the result of a settlement or

judgment of a claim of medical

malpractice. The regulations also state

that the report will identify the

practitioner for whose benefit the

payment is made. Currently, the

regulations provide for facility directors

to file a report when they affirm a

recommendation from a peer review

body regarding whether payment was

made for the benefit of a practitioner.

Also, currently the regulations provide

that the peer review bodies are to be

appointed by facility directors. We

propose to change the delegation of

authority for making the determinations

of whether payment was made for the

benefit of a practitioner by delegating

this function to malpractice payment

review panels appointed by the Director

of Medical-Legal Affairs. We believe

that this will be a more efficient process

and help ensure independent

decisionmaking. We propose that this

new process be used in all cases for

which a panel is appointed on or after

the effective date of the final rule.

The current regulations further

provide for reporting to the NPDB if it

is determined that payment was made

for the benefit of a practitioner. We

propose to delegate this reporting

authority to the Director of the facility

in which the acts or omissions occurred

and the Chief Patient Care Services

Officer. These are the appropriate

reporting officials within VA. Further,

to help ensure that the reported

practitioner is aware of the reporting,

the reporting official would be required

to send a copy of the report to the

reported practitioner.

For malpractice payment

determinations, the current regulations

provide for review of documents

pertinent to the claim, including, to the

extent practicable, information collected

directly from the individual for whose

benefit payment was made. The

regulations also provide that individuals

under consideration for malpractice

payment reporting are to be given an

opportunity for discussion with the

facility director and any other

individual designated by the facility

director before a reporting

determination is made. We propose to

eliminate the discussion provisions and

otherwise change these procedures as

follows:

• Written notice shall be provided to

the practitioner whose actions are under

review stating that VA is considering

whether to report the practitioner to the

NPDB because of a specified

malpractice payment made, and

providing the practitioner with the

opportunity to submit a written

statement concerning the care that led to

the claim within 30 days of receipt of

the notice. The written notice shall be

hand-delivered to the practitioner

whose actions are under review or sent

return-receipt requested to the last

known address of such practitioner.

• Prior to making a determination, the

malpractice payment review panel will

review documents pertinent to the care

that led to the claim. This may include

30142 Federal Register / Vol. 66, No. 108 / Tuesday, June 5, 2001 / Proposed Rules

information prepared in response to a

request from the panel.

We believe these procedures provide

for more efficient and timely reporting

while preserving the practitioner’s right

to fair and impartial consideration of his

or her actions.

With respect to malpractice payment

reporting, we also propose to establish

special reporting criteria for licensed

trainees and for health care

professionals who supervise trainees.

We propose that actions of a licensed

trainee acting within the scope of his or

her training program that otherwise

would warrant reporting for

substandard care, professional

incompetence, or professional

misconduct will be reported only if the

panel, by at least a majority, concludes

that such actions constitute gross

negligence or willful professional

misconduct. Also, we propose to report

a physician, dentist, or other health care

practitioner in their supervisory

capacity, if the panel concludes, by at

least a majority, that the health care

practitioner was acting in a supervisory

capacity when the event occurred; that

the payment was related to substandard

care, professional incompetence, or

professional misconduct of the trainee

and not the supervisor; and that the

trainee did not commit gross negligence

or willful misconduct. Such report

would note that the physician, dentist,

or other health care practitioner is being

reported in a supervisory capacity.

These provisions are intended to ensure

that reporting reflects responsibility for

actions.

With respect to malpractice payment

reporting, the regulations currently state

that it is intended that malpractice

reports be filed within 30 days of the

date payment is made. However, the

regulations acknowledge that VA may

not be able to report within 30 days if

VA is not notified of such payments

within sufficient time to report within

the 30-day period. We propose to add an

additional example specifically

acknowledging that the 30-day period

would not be met if the malpractice

payment review process were delayed.

The examples are designed to ensure

that VA officials understand that

reporting must still occur even if there

is a valid reason for not reporting within

the 30-day period.

In addition, we propose to add

provisions regarding both malpractice

payment reporting and clinical

privileges actions reporting. We propose

to add provisions stating that NPDB

reporting, including copies to State

Licensing Boards, may not be the

subject of any negotiation in any

settlement agreement, employee action,

legal proceedings, or any other

negotiated settlement. Also, we propose

to note that independent contractors are

subject to NPDB reporting under the

regulations. We believe these provisions

are consistent with the statutory

framework for establishing NPDB

reporting (42 U.S.C. 11101–11157).

Further, this policy will help ensure

that NPDB reporting occurs when

warranted.

The provisions of § 46.4 set forth a

mechanism for reporting based on

actions regarding clinical privileges.

The current provisions inadvertently

indicated that the original report and a

copy would be filed with the State

Licensing Board in the State in which

the facility is located, and a copy filed

with the State Licensing Board in the

State(s) in which the practitioner is

licensed. However, this would be

corrected to state that the report will be

filed with the National Practitioner Data

Bank, with a copy to the State Licensing

Board in the State(s) in which the

practitioner is licensed and in which the

facility is located.

The current regulations at § 46.4(a)(2)

provide that one basis for reporting to

the NPDB is the acceptance of the

surrender of clinical privileges or any

restriction of such privileges by a

physician or dentist either while under

investigation by the health care entity

relating to possible incompetence or

improper professional conduct, or in

return for not conducting such an

investigation or proceeding. We propose

to specify that the acceptance of the

surrender of clinical privileges would

include the surrender of clinical

privileges inherent in resignation or

retirement. We believe that the need for

reporting would be the same regardless

of how an individual surrendered these

clinical privileges. Also, to advise

affected individuals of the reporting

under § 46.4(a)(2) and to advise them

that copies will be sent to State

Licensing Boards, we propose to require

that, as soon as practicable following the

determination to report, VA shall

provide written notice to the

practitioner that a report shall be filed

with the National Practitioner Data Bank

with a copy to the State Licensing Board

in each State in which the practitioner

is licensed and in the State in which the

facility is located.

We also propose to make

nonsubstantive changes for purposes of

clarity, including adding legal

definitions of ‘‘gross negligence’’ and

‘‘willful professional misconduct.’’

Paperwork Reduction Act of 1995

Under the Paperwork Reduction Act

of 1995 (44 U.S.C. 3501–3520), a

collection of information is set forth in

proposed 38 CFR 46.3(c). Accordingly,

under section 3507(d) of the Act, VA

has submitted a copy of this rulemaking

action to the Office of Management and

Budget (OMB) for its review of the

proposed collection of information.

OMB assigns a control number for

each collection of information it

approves. VA may not conduct or

sponsor, and a person is not required to

respond to, a collection of information

unless it displays a currently valid OMB

control number.

Comments on the proposed collection

of information should be submitted to

the Office of Management and Budget,

Attention: Desk Officer for the

Department of Veterans Affairs, Office

of Information and Regulatory Affairs,

Washington, DC 20503, with copies

mailed or hand-delivered to: Director,

Office of Regulations Management

(02D), Department of Veterans Affairs,

810 Vermont Avenue, N.W., Room 1154,

Washington, DC 20420. Comments

should indicate that they are submitted

in response to ‘‘RIN 2900–AJ76.’’

Title: Submission of Evidence.

Summary of collection of information:

Under proposed § 46.3(c), written notice

shall be provided to the practitioner

whose actions are under review stating

that VA is considering whether to report

the practitioner to the NPDB because of

a specified malpractice payment made,

and provide the practitioner with the

opportunity within 30 days of receipt to

submit a written statement concerning

the care which led to the malpractice

payment. The peer review panel would

also request written information as

needed.

Description of need for information

and proposed use of information: This

information would be needed for the

malpractice payment review panels to

determine whether an affected health

care professional should be reported to

the NPDB.

Description of likely respondents:

Health care professionals who are under

consideration for reporting to the NPDB

and any other individual involved in

the care, which led to a claim resulting

in a malpractice payment.

Estimated number of respondents:

350 per year.

Estimated frequency of responses: 1

per year.

Estimated average burden per

collection: 5 hours.

Estimated total annual reporting and

recordkeeping burden: 1750 hours.

The Department considers comments

by the public on proposed collections of

information in—

• Evaluating whether the proposed

collections of information are necessary

Federal Register / Vol. 66, No. 108 / Tuesday, June 5, 2001 / Proposed Rules 30143

for the proper performance of the

functions of the Department, including

whether the information will have

practical utility;

• Evaluating the accuracy of the

Department’s estimate of the burden of

the proposed collections of information,

including the validity of the

methodology and assumptions used;

• Enhancing the quality, usefulness,

and clarity of the information to be

collected; and

• Minimizing the burden of the

collections of information on those who

are to respond, including through the

use of appropriate automated,

electronic, mechanical, or other

technological collection techniques or

other forms of information technology,

e.g., permitting electronic submission of

responses.

OMB is required to make a decision

concerning the collection of information

contained in this proposed rule between

30 and 60 days after publication of this

document in the Federal Register.

Therefore, a comment to OMB is best

assured of having its full effect if OMB

receives it within 30 days of

publication. This does not affect the

deadline for the public to comment on

the proposed regulations.

Executive Order 12866

This document has been reviewed by

the Office of Management and Budget

under Executive Order 12866.

Regulatory Flexibility Act

The Secretary hereby certifies that the

adoption of this proposed rule would

not have a significant economic impact

on a substantial number of small entities

as they are defined in the Regulatory

Flexibility Act, 5 U.S.C. 601–612. This

rulemaking proceeding affects only

individuals. Accordingly, pursuant to 5

U.S.C. 605(b), this proposed rule is

exempt from the initial and final

regulatory flexibility analyses

requirements of §§ 603 and 604.

The Catalog of Federal Domestic Assistance

numbers for the programs affected by this

document are 64.005, 64.007, 64.008, 64,009,

64.010, 64.011, 64.012, 64.013, 64.014,

64.015, 64.016, 64.018, 64.019, 64.022, 640–

024, and 64.025.

List of Subjects in 38 CFR Part 46

Health professions.

Approved: February 28, 2001.

Anthony J. Principi,

Secretary of Veterans Affairs.

For the reasons set forth in the

preamble, 38 CFR part 46 is proposed to

be revised as follows:

PART 46—POLICY REGARDING

PARTICIPATION IN NATIONAL

PRACTITIONER DATA BANK

Subpart A—General Provisions

Sec.

46.1 Definitions.

46.2 Purpose.

Subpart B—National Practitioner Data Bank

Reporting

46.3 Malpractice payment reporting.

46.4 Clinical privileges actions reporting.

Subpart C—National Practitioner Data Bank

Inquiries

46.5 National Practitioner Data Bank

inquiries.

Subpart D—Miscellaneous

46.6 Medical quality assurance records

confidentiality.

46.7 Prohibitions concerning negotiations.

46.8 Independent contractors.

Authority: 38 U.S.C. 501; 42 U.S.C. 11101–

11152

Subpart A—General Provisions

§ 46.1 Definitions.

(a) Act means The Health Care Quality

Improvement Act of 1986, as amended

(42 U.S.C. 11101–11152).

(b) Claim of medical malpractice

means a written claim or demand for

payment based on an act or omission of

a physician, dentist, or other health care

practitioner in furnishing (or failing to

furnish) health care services, and

includes the filing of a complaint or

administrative tort claim under the

Federal Tort Claims Act, 28 U.S.C.

1346(b), 2671–2680.

(c) Clinical privileges means

privileges granted by a health care entity

to individuals to furnish health care.

(d) Dentist means a doctor of dental

surgery or dental medicine legally

authorized to practice dental surgery or

dentistry by a State (or any individual

who holds himself or herself out to be

so authorized).

(e) Director means the duly appointed

director of a Department of Veterans

Affairs health care facility or any

individual with authorization to act for

that person in the director’s absence.

(f) Gross negligence is materially

worse than substandard care, and

consists of an entire absence of care, or

an absence of even slight care or

diligence; it implies a thoughtless

disregard of consequences or

indifference to the rights of others.

(g) Health care facility means a

hospital, domiciliary, outpatient clinic,

or any other entity that provides health

care services.

(h) Other health care practitioner

means an individual other than a

physician or dentist who is licensed or

otherwise authorized by a State to

provide health care services.

(i) Physician means a doctor of

medicine or osteopathy authorized to

practice medicine or surgery by a State

(or any individual who holds himself or

herself out to be so authorized).

(j) Professional review action means a

recommendation by a professional

review panel (with at least a majority

vote) to affect adversely the clinical

privileges of a physician or dentist taken

as a result of a professional review

activity based on the competence or

professional conduct of an individual

physician or dentist in cases in which

such conduct affects or could affect

adversely the health or welfare of a

patient, or patients. An action is not

considered to be based on the

competence or professional conduct of a

physician or dentist, if the action is

primarily based on:

(1) A physician’s or dentist’s

association with, administrative

supervision of, delegation of authority

to, support for, or training of, a member

or members of a particular class of

health care practitioner or professional,

or

(2) Any other matter that does not

relate to the competence or professional

conduct of a physician or dentist in his/

her practice at a Department of Veterans

Affairs health care facility.

(k) Professional review activity means

an activity with respect to an individual

physician or dentist to establish a

recommendation regarding:

(1) Whether the physician or dentist

may have clinical privileges with

respect to the medical staff of the

facility;

(2) The scope or conditions of such

privileges or appointment; or

(3) Change or modification of such

privileges.

(l) State means the fifty States, the

District of Columbia, Puerto Rico, the

Virgin Islands, Guam, American Samoa,

the Northern Mariana Islands, and any

other territories or possessions of the

United States.

(m) State Licensing Board means,

with respect to a physician, dentist, or

other health care practitioner in a State,

the agency of the State, which is

primarily responsible for the licensing

of the physician, dentist, or practitioner

to furnish health care services.

(n) Willful professional misconduct

means worse than mere substandard

care, and contemplates the intentional

doing of something with knowledge that

it is likely to result in serious injuries

or in reckless disregard of its probable

consequences.

30144 Federal Register / Vol. 66, No. 108 / Tuesday, June 5, 2001 / Proposed Rules

§ 46.2 Purpose.

The National Practitioner Data Bank,

authorized by the Act and administered

by the Department of Health and Human

Services, was established for the

purpose of collecting and releasing

certain information concerning

physicians, dentists, and other health

care practitioners. The Act mandates

that the Department of Health and

Human Services seek to enter into a

Memorandum of Understanding with

the Department of Veterans Affairs (VA)

for the purpose of having VA participate

in the National Practitioner Data Bank.

Such a Memorandum of Understanding

has been established. Pursuant to the

Memorandum of Understanding, VA

will obtain information from the Data

Bank concerning physicians, dentists,

and other health care practitioners who

provide or seek to provide health care

services at VA facilities and also report

information regarding malpractice

payments and adverse clinical

privileges actions to the Data Bank. This

part essentially restates or interprets

provisions of that Memorandum of

Understanding and constitutes the

policy of VA for participation in the

National Practitioner Data Bank.

Subpart B—National Practitioner Data

Bank Reporting

§ 46.3 Malpractice payment reporting.

(a) VA will file a report with the

National Practitioner Data Bank, in

accordance with regulations at 45 CFR

part 60, subpart B, as applicable,

regarding any payment for the benefit of

a physician, dentist, or other licensed

health care practitioner which was

made as the result of a settlement or

judgment of a claim of medical

malpractice. The report will identify the

physician, dentist, or other licensed

health care practitioner for whose

benefit the payment is made. It is

intended that the report be filed within

30 days of the date payment is made.

This may not be possible in all cases;

e.g., sometimes notification of payment

is delayed, and sometimes the

malpractice payment review process

cannot be completed within the

timeframe. The report will provide the

following information:

(1) With respect to the physician,

dentist, or other licensed health care

practitioner for whose benefit the

payment is made—

(i) Name;

(ii) Work address;

(iii) Home address, if known;

(iv) Social Security number, if known,

and if obtained in accordance with

section 7 of the Privacy Act of 1974;

(v) Date of birth;

(vi) Name of each professional school

attended and year of graduation;

(vii) For each professional license: the

license number, the field of licensure,

and the State in which the license is

held;

(viii) Drug Enforcement

Administration registration number, if

applicable and known;

(ix) Name of each health care entity

with which affiliated, if known.

(2) With respect to the reporting VA

entity—

(i) Name and address of the reporting

entity;

(ii) Name, title and telephone number

of the responsible official submitting the

report on behalf of the Federal

government; and

(iii) Relationship of the entity to the

physician, dentist, or other health care

practitioner being reported.

(3) With respect to the judgment or

settlement resulting in the payment—

(i) Where an action or claim has been

filed with an adjudicative body,

identification of the adjudicative body

and the case number;

(ii) Date or dates on which the act(s)

or omission(s), which gave rise to the

action or claim occurred;

(iii) Date of judgment or settlement;

(iv) Amount paid, date of payment,

and whether payment is for a judgment

or a settlement;

(v) Description and amount of

judgment or settlement and any

conditions attached thereto, including

terms of payment;

(vi) A description of the acts or

omissions and injuries or illnesses upon

which the action or claim was based;

and

(vii) Classification of the acts or

omissions in accordance with a

reporting code adopted by the Secretary

of Health and Human Services.

(b) Payment will be considered to

have been made for the benefit of a

physician, dentist, or other licensed

health care practitioner only if (at least

a majority of) a malpractice payment

review panel concludes that payment

was related to substandard care,

professional incompetence, or

professional misconduct on the part of

the physician, dentist, or other licensed

health care practitioner. For purposes of

this part, a panel shall have a minimum

of three individuals appointed by the

Director, Medical-Legal Affairs

(including at least one member of the

profession/occupation of the

practitioner(s) whose actions are under

review). The conclusions of the panel

shall, at a minimum, be based on review

of documents pertinent to the care that

led to the claim. These documents

include the medical records of the

patient whose care led to the claim, any

report of an administrative investigation

board appointed to investigate the care,

and the opinion of any consultant

which the panel may request in its

discretion. These documents do not

include those generated primarily for

consideration or litigation of the claim

of malpractice. In addition, to the extent

practicable, the documents shall include

written statements of the individual(s)

involved in the care which led to the

claim. The practitioner(s) whose actions

are under review will receive a written

notice, hand-delivered or sent to the

practitioner’s last known address (return

receipt requested). That notice will

indicate that VA is considering whether

to report the practitioner to the National

Practitioner Data Bank because of a

specified malpractice payment made,

and provide the practitioner the

opportunity, within 30 days of receipt,

to submit a written statement

concerning the care that led to the

claim. Inability to notify or nonresponse from the identified

practitioner(s) will not preclude

completion of the review and reporting

process. The panel, at its discretion,

may request additional information

from the practitioner or the VA facility

where the incident occurred.

(c) Attending staff (including contract

employees, such as scarce medical

specialists providing care pursuant to a

contract under 38 U.S.C. 7409) are

responsible for actions of licensed

trainees assigned under their

supervision. Notwithstanding the

provisions of paragraph (b) of this

section, actions of a licensed trainee

(intern or resident) acting within the

scope of his or her training program that

otherwise would warrant reporting for

substandard care, professional

incompetence, or professional

misconduct under the provisions of

paragraph (b) of this section, will be

reported only if the panel, by at least a

majority, concludes that such actions

constitute gross negligence or willful

professional misconduct. For purposes

of paragraph (b) of this section, payment

will be considered to be made for the

benefit of a physician, dentist, or other

health care practitioner, in their

supervisory capacity, if the panel

concludes, by at least a majority, that

the physician, dentist or other health

care practitioner was acting in a

supervisory capacity; that the payment

was related to substandard care,

professional incompetence, or

professional misconduct of the trainee

and not the supervisor; and that the

trainee did not commit gross negligence

or willful professional misconduct.

Federal Register / Vol. 66, No. 108 / Tuesday, June 5, 2001 / Proposed Rules 30145

Such report will note that the physician,

dentist, or other health care practitioner

is being reported in a supervisory

capacity.

Note to paragraph (c): Licensed trainees

acting outside the scope of their training

program (e.g. acting as admitting officer of

the day) will be reported under the

provisions of paragraph (b) of this section.

(d) The Director of the facility at

which the claim arose has the primary

responsibility for submitting the report

to the National Practitioner Data Bank

and for providing a copy to the

practitioner, to the State Licensing

Board in each State where the

practitioner holds a license, and to the

State Licensing Board in which the

facility is located. However, the Chief

Patient Care Services Officer is also

authorized to submit the report to the

National Practitioner Data Bank and

provide copies to the practitioner and

State Licensing Boards in cases where

the Chief Patient Care Services Officer

deems it appropriate to do so.

§ 46.4 Clinical privileges actions reporting.

(a) VA will file an adverse action

report with the National Practitioner

Data Bank in accordance with

regulations at 45 CFR part 60, subpart B,

as applicable, regarding any of the

following actions:

(1) An action of a Director after

consideration of a professional review

action that, for a period longer than 30

days, adversely affects (by reducing,

restricting, suspending, revoking, or

failing to renew) the clinical privileges

of a physician or dentist relating to

possible incompetence or improper

professional conduct.

(2) Acceptance of the surrender of

clinical privileges, including the

surrender of clinical privileges inherent

in resignation or retirement, or any

restriction of such privileges by a

physician or dentist either while under

investigation by the health care entity

relating to possible incompetence or

improper professional conduct, or in

return for not conducting such an

investigation or proceeding whether or

not the individual remains in VA

service.

(b) The report specified in paragraph

(a) of this section will provide the

following information—

(1) With respect to the physician or

dentist:

(i) Name;

(ii) Work address;

(iii) Home address, if known;

(iv) Social Security number, if known

(and if obtained in accordance with

section 7 of the Privacy Act of 1974);

(v) Date of birth;

(vi) Name of each professional school

attended and year of graduation;

(vii) For each professional license: the

license number, the field of licensure,

and the name of the State in which the

license is held;

(viii) Drug Enforcement

Administration registration number, if

applicable and known;

(ix) A description of the acts or

omissions or other reasons for privilege

loss, or, if known, for surrender; and

(x) Action taken, date action was

made final, length of action and

effective date of the action.

(2) With respect to the VA facility—

(i) Name and address of the reporting

facility; and

(ii) Name, title, and telephone number

of the responsible official submitting the

report.

(c) A copy of the report referred to in

paragraph (a) of this section will also be

filed with the State Licensing Board in

the State(s) in which the practitioner is

licensed and in which the facility is

located. It is intended that the report be

filed within 15 days of the date the

action is made final, that is, subsequent

to any internal (to the facility) appeal.

(d) As soon as practicable after it is

determined that a report shall be filed

with the National Practitioner Data Bank

and State Licensing Boards under

paragraphs (a)(2) and (c) of this section,

VA shall provide written notice to the

practitioner that a report will be filed

with the National Practitioner Data Bank

with a copy to the State Licensing Board

in each State in which the practitioner

is licensed and in the State in which the

facility is located.

Subpart C—National Practitioner Data

Bank Inquiries

§ 46.5 National Practitioner Data Bank

inquiries.

VA will request information from the

National Practitioner Data Bank, in

accordance with the regulations

published at 45 CFR part 60, subpart C,

as applicable, concerning a physician,

dentist, or other licensed health care

practitioner as follows:

(a) At the time a physician, dentist, or

other health care practitioner applies for

a position at VA Central Office, any of

its regional offices, or on the medical

staff, or for clinical privileges at a VA

hospital or other health care entity

operated under the auspice of VA;

(b) No less often than every 2 years

concerning any physician, dentist, or

other health care practitioner who is on

the medical staff or who has clinical

privileges at a VA hospital or other

health care entity operated under the

auspice of VA; and

(c) At other times pursuant to VA

policy and needs and consistent with

the Act and Department of Health and

Human Services Regulations (45 CFR

part 60).

Subpart D—Miscellaneous

§ 46.6 Medical quality assurance records

confidentiality.

Note that medical quality assurance

records that are confidential and

privileged under the provisions of 38

U.S.C. 5705 may not be used as

evidence for reporting individuals to the

National Practitioner Data Bank.

§ 46.7 Prohibitions concerning

negotiations.

Reporting under this part (including

the submission of copies) may not be

the subject of negotiation in any

settlement agreement, employee action,

legal proceedings, or any other

negotiated settlement.

§ 46.8 Independent contractors.

Independent contractors acting on

behalf of the Department of Veterans

Affairs are subject to the National

Practitioner Data Bank reporting

provisions of this part. In the following

circumstances, VA will provide the

contractor with notice that a report of a

clinical privileges action will be filed

with the National Practitioner Data Bank

with a copy with the State Licensing

Board in the State(s) in which the

contractor is licensed and in which the

facility is located: where VA terminates

a contract for possible incompetence or

improper professional conduct, thereby

automatically revoking the contractor’s

clinical privileges, or where the

contractor terminates the contract,

thereby surrendering clinical privileges,

either while under investigation relating

to possible incompetence or improper

professional conduct or in return for not

conducting such an investigation or

proceeding.

(Authority: 38 U.S.C. 5705)

[FR Doc. 01–13989 Filed 6–4–01; 8:45 am]

BILLING CODE 8320–01–P

ENVIRONMENTAL PROTECTION

AGENCY

40 CFR Part 52

[CA 242–0281; FRL–6990–8]

Revisions to the California State

Implementation Plan, Imperial County

Air Pollution Control District

AGENCY: Environmental Protection

Agency (EPA).

ACTION: Proposed rule.