Mandatory Reporting

• Health Facility/Peer Review Reporting Form as required by 805
• Medical Malpractice Reporting (801)

Health Facility/Peer Review Reporting Form as required by 805

An 805 report is the mechanism in which peer review bodies, most commonly found in hospitals, are required to report specific information regarding licensees to the Medical Board.

An 805 Report must be filed if one of the following actions occurs:

• A peer review body denies or rejects a licensee’s applications for staff privileges or membership for a medical disciplinary cause or reason;
• A licensee’s staff privileges, membership, or employment are revoked for a medical disciplinary cause or reason;
• Restrictions are imposed, or voluntarily accepted, on staff privileges, membership, or employment for a total of 30 days or more within any 12 month period for medical disciplinary reasons;
• If the resignation, leave of absence, withdrawal or abandonment of application or for renewal of privileges occurs after receiving notice of a pending investigation initiated for a medical disciplinary cause or reason;
• A summary suspension of staff privileges, membership, or employment is imposed for a period in excess of 14 days.

An 805 Report must be filed within 15 days after:

• The effective date of the action to deny or reject an application for staff privileges or membership;
• The effective date of the action to revoke staff privileges, membership, or employment;
• The effective date of the action to impose restrictions on staff privileges, membership, or employment for a total of 30 days or more within any 12 month period;
• The Imposition of a summary suspension of staff privileges, membership, or employment for a period in excess of 14 days;
• The licentiate resigns, takes a leave of absence, withdraws or abandons the application for privileges or the application to renew privileges after receiving notice of a pending investigation.

"Medical disciplinary cause or reason" as defined in 805(a)(6) means that aspect of a licentiate's competence or professional conduct that is reasonably likely to be detrimental to patient safety or to the delivery of patient care.

Any peer review body from:

• A health care facility or clinic licensed under Division 2 of the Health and Safety Code or a facility certified to participate in the federal Medicare Program as an ambulatory surgical center.
• A health care service plan licensed under Chapter 2.2 of Division 2 of the Health and Safety Code or a disability insurer that contracts with licentiates.
• A medical or podiatric professional society having as members at least 25% of the eligible licentiates in the area in which it functions, which is not organized for profit and which has been determined to be exempt from taxes.
• A committee organized by any entity consisting of or employing more than 25 licentiates of the same class that functions for the purpose of reviewing the quality of care provided by members or employees.

• The chief of staff of a medical or professional staff;
• Other chief executive officer;
• Medical director, or administrator of any peer review body; or
• Chief executive officer or administrator of any licensed health care facility or clinic.

• Name of licensee
• License number; and
• Description of the facts and circumstances of the medical disciplinary cause or reason and any other relevant information deemed appropriate by the reporter.

805 reports are not public documents available to consumers; however, copies may be requested by certain health care facilities licensed pursuant to California Health and Safety Code 1200-1209 for credentialing purposes. This does not cause the 805 report to become public record.

Only if the 805 report indicates hospital disciplinary action that resulted in the termination or revocation of a licensees' staff privileges based on medical disciplinary cause or reason. The licensee’s profile will display “Hospital Discipline” as secondary status. Further details are available under the Public Record Actions section. The extent of detail available is limited to the reporting entity name, a brief description of action, and effective date of action.

Failure to report may result in a $50,000 fine per violation. Intentional or willful failure to report may result in a $100,000 fine per violation.

Pursuant to Business and Professions Code Sections 800 and 805(f), a licensee may submit “additional exculpatory or explanatory statements” to supplement the 805 report. This addendum will be disseminated with the 805 report to any eligible requesting party.

805.01 report is a mechanism in which peer review bodies are required to report a final decision or recommendation of certain actions being taken against a licensee after an investigation.

Yes. An 805 report is still required once the recommendations are made final by the reporting entity. The main objective of the 805.01 is to allow the Board to expedite the investigation process.

805.01 reports are not disseminated and not posted on a licensee’s profile.

Medical Malpractice Reporting (801)

Yes.

If the malpractice action strictly involved a "system" problem and an D.O. was not named in the claim/action, a report need not be filed with the OMBC.

A report need not be filed with the Osteopathic Medical Board but there may be reporting requirements to other professional licensing boards or bureaus.

No. Reporting is intended to alert the Osteopathic Medical Board to situations where a licensed practitioner may be negligent or incompetent in their professional practice. Residents, interns, and medical students have not established that they possess the minimum entry level competence. The purpose of the statute requiring reporting is not served by requiring a report where the incident occurred before the practitioner became licensed.

Yes. The law requires that any medical malpractice judgment or arbitration award of any amount or settlement over $30,000 that relates to a licensee's alleged negligence, error or omission in practice be reported, regardless of where the care and treatment occurred. While the Osteopathic Medical Board of California would not review the underlying circumstances in the malpractice case as the treatment occurred outside of California, the involvement in the malpractice case would count as part of the accumulated total which may result in public disclosure.

Unless the settlement/judgment/arbitration award specifically apportions an amount to each particular physician named in the claim or action, the Medical Board will attribute the full amount of the award to each physician named.

No.

Yes. If no amount is shown as paid on behalf of the physician, the Osteopathic Medical Board will attribute the entire amount of the settlement to each named physician.