---
kind: "section"
citation: "42 U.S.C. § 1396r–2"
title: "42"
title_heading: "The Public Health and Welfare"
number: "1396r–2"
heading: "Information concerning sanctions taken by State licensing authorities against health care practitioners and providers"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/1396r-2"
units:
  - "Chapter 7 — Social Security"
  - "Subchapter XIX — Grants to States for Medical Assistance Programs"
---

# §1396r–2. Information concerning sanctions taken by State licensing authorities against health care practitioners and providers

- (a) **Information reporting requirement—** The requirement referred to in [section 1396a(a)(49) of this title](/usc/42/1396a.md?p=a-49) is that the [State](/usc/42/619.md?p=5) must provide for the following:
  - (1) **Information reporting system—**
    - (A) **Licensing or certification actions—** The [State](/usc/42/619.md?p=5) must have in effect a system of reporting the following information with respect to formal proceedings (as defined by the [Secretary](/usc/42/1301.md?p=a-6) in regulations) concluded against a health care practitioner or entity by a [State](/usc/42/619.md?p=5) licensing or certification [agency](/usc/42/1397n–12.md?p=1):
      - (i) Any adverse action taken by such licensing authority as a result of the proceeding, [including](/usc/42/1301.md?p=b) any revocation or suspension of a license (and the length of any such suspension), reprimand, censure, or probation.
      - (ii) Any dismissal or closure of the proceedings by reason of the practitioner or entity surrendering the license or leaving the [State](/usc/42/619.md?p=5) or jurisdiction.
      - (iii) Any other loss of license or the right to apply for, or renew, a license by the practitioner or entity, whether by operation of law, voluntary surrender, nonrenewability, or otherwise.
      - (iv) Any negative action or finding by such authority, organization, or entity regarding the practitioner or entity.
    - (B) **Other final adverse actions—** The [State](/usc/42/619.md?p=5) must have in effect a system of reporting information with respect to any final adverse action (not [including](/usc/42/1301.md?p=b) settlements in which no findings of liability have been made) taken against a [health care provider](/usc/42/1320d.md?p=3), supplier, or practitioner by a [State](/usc/42/619.md?p=5) law or fraud enforcement [agency](/usc/42/1397n–12.md?p=1).
  - (2) **Access to documents—** The [State](/usc/42/619.md?p=5) must provide the [Secretary](/usc/42/1301.md?p=a-6) (or an entity designated by the [Secretary](/usc/42/1301.md?p=a-6)) with access to such documents of a [State](/usc/42/619.md?p=5) licensing or certification [agency](/usc/42/1397n–12.md?p=1) or [State](/usc/42/619.md?p=5) law or fraud enforcement [agency](/usc/42/1397n–12.md?p=1) as may be necessary for the [Secretary](/usc/42/1301.md?p=a-6) to determine the facts and circumstances concerning the actions and determinations described in such paragraph for the purpose of carrying out this chapter.
- (b) **Form of information—** The information described in [subsection (a)(1)](#a-1) shall be provided to the [Secretary](/usc/42/1301.md?p=a-6) (or to an appropriate private or [public agency](/usc/42/11851.md?p=8), under suitable arrangements made by the [Secretary](/usc/42/1301.md?p=a-6) with respect to receipt, storage, protection of confidentiality, and dissemination of information) in such a form and manner as the [Secretary](/usc/42/1301.md?p=a-6) determines to be appropriate in order to provide for activities of the [Secretary](/usc/42/1301.md?p=a-6) under this chapter and in order to provide, directly or through suitable arrangements made by the [Secretary](/usc/42/1301.md?p=a-6), information—
  - (1) to [agencies](/usc/42/1397n–12.md?p=1) administering Federal health care programs, [including](/usc/42/1301.md?p=b) private entities administering such programs under contract,
  - (2) to [State](/usc/42/619.md?p=5) licensing or certification [agencies](/usc/42/1397n–12.md?p=1) and Federal [agencies](/usc/42/1397n–12.md?p=1) responsible for the licensing and certification of [health care providers](/usc/42/1320d.md?p=3), suppliers, and licensed health care practitioners;[^1]
  - (3) to [State agencies](/usc/42/629a.md?p=a-3) administering or supervising the [administration](/usc/42/1301.md?p=a-10) of [State](/usc/42/619.md?p=5) health care programs (as defined in [section 1320a–7(h) of this title](/usc/42/1320a–7.md?p=h)),
  - (4) to utilization and quality control peer review organizations[^2] described in part B of subchapter XI and to appropriate entities with contracts under [section 1320c–3(a)(4)(C)](/usc/42/1320c–3.md)[^3] of this title with respect to eligible organizations reviewed under the contracts, but only with respect to information provided pursuant to [subsection (a)(1)(A)](#a-1-A),
  - (5) to [State](/usc/42/619.md?p=5) law or fraud enforcement [agencies](/usc/42/1397n–12.md?p=1),
  - (6) to [hospitals](/usc/42/300s–3.md?p=1) and other health care entities (as defined in section 431 of the Health Care Quality Improvement Act of 1986 [[42 U.S.C. 11151](/usc/42/11151.md)]), with respect to [physicians](/usc/42/1301.md?p=a-7) or other licensed health care practitioners that have entered (or may be entering) into an employment or affiliation relationship with, or have applied for clinical privileges or appointments to the medical staff of, such [hospitals](/usc/42/300s–3.md?p=1) or other health care entities (and such information shall be deemed to be disclosed pursuant to [section 427](/usc/42/427.md) [[42 U.S.C. 11137](/usc/42/11137.md)] of, and be subject to the provisions of, that Act [[42 U.S.C. 11101](/usc/42/11101.md) et seq.]), but only with respect to information provided pursuant to [subsection (a)(1)(A)](#a-1-A),
  - (7) to [health plans](/usc/42/1320d.md?p=5) (as defined in [section 1320a–7c(c) of this title](/usc/42/1320a–7c.md?p=c));[^1]
  - (8) to the Attorney General and such other [law enforcement](/usc/42/1397j.md?p=13) officials as the [Secretary](/usc/42/1301.md?p=a-6) deems appropriate, and
  - (9) upon request, to the Comptroller General,

  in order for such authorities to determine the fitness of individuals to provide health care services, to protect the health and safety of individuals receiving health care through such programs, and to protect the fiscal integrity of such programs.

- (c) **Confidentiality of information provided—** The [Secretary](/usc/42/1301.md?p=a-6) shall provide for suitable safeguards for the confidentiality of the information furnished under [subsection (a)](#a). Nothing in this subsection shall prevent the disclosure of such information by a party which is otherwise authorized, under applicable [State](/usc/42/619.md?p=5) law, to make such disclosure.
- (d) **Disclosure and correction of information—**
  - (1) **Disclosure—** With respect to information reported pursuant to [subsection (a)(1)](#a-1), the [Secretary](/usc/42/1301.md?p=a-6) shall—
    - (A) provide for disclosure of the information, upon request, to the health care practitioner who, or the entity that, is the subject of the information reported; and
    - (B) establish procedures for the case where the health care practitioner or entity disputes the accuracy of the information reported.
  - (2) **Corrections—** Each [State](/usc/42/619.md?p=5) licensing or certification [agency](/usc/42/1397n–12.md?p=1) and [State](/usc/42/619.md?p=5) law or fraud enforcement [agency](/usc/42/1397n–12.md?p=1) shall report corrections of information already reported about any formal proceeding or final adverse action described in [subsection (a)](#a), in such form and manner as the [Secretary](/usc/42/1301.md?p=a-6) prescribes by regulation.
- (e) **Fees for disclosure—** The [Secretary](/usc/42/1301.md?p=a-6) may establish or approve reasonable fees for the disclosure of information under this section. The amount of such a fee may not exceed the costs of processing the requests for disclosure and of providing such information. Such fees shall be available to the [Secretary](/usc/42/1301.md?p=a-6) to cover such costs.
- (f) **Protection from liability for reporting—** No [person](/usc/42/1301.md?p=a-3) or entity, [including](/usc/42/1301.md?p=b) any [agency](/usc/42/1397n–12.md?p=1) designated by the [Secretary](/usc/42/1301.md?p=a-6) in [subsection (b)](#b), shall be held liable in any civil action with respect to any reporting of information as required under this section, without knowledge of the falsity of the information contained in the report.
- (g) **References—** For purposes of this section:
  - (1) **State licensing or certification agency—** The term “[State](/usc/42/619.md?p=5) licensing or certification [agency](/usc/42/1397n–12.md?p=1)” [includes](/usc/42/1301.md?p=b) any authority of a [State](/usc/42/619.md?p=5) (or of a political subdivision thereof) responsible for the licensing of health care practitioners (or any peer review organization or private accreditation entity reviewing the services provided by health care practitioners) or entities.
  - (2) **State law or fraud enforcement agency—** The term “[State](/usc/42/619.md?p=5) law or fraud enforcement [agency](/usc/42/1397n–12.md?p=1)” [includes](/usc/42/1301.md?p=b)—
    - (A) a [State](/usc/42/619.md?p=5) [law enforcement](/usc/42/1397j.md?p=13) [agency](/usc/42/1397n–12.md?p=1); and
    - (B) a [State](/usc/42/619.md?p=5) medicaid fraud control unit (as defined in [section 1396b(q) of this title](/usc/42/1396b.md?p=q)).
  - (3) **Final adverse action—**
    - (A) **In general—** Subject to [subparagraph (B)](#g-3-B), the term “final adverse action” [includes](/usc/42/1301.md?p=b)—
      - (i) civil judgments against a [health care provider](/usc/42/1320d.md?p=3), supplier, or practitioner in [State](/usc/42/619.md?p=5) court related to the delivery of a health care item or service;
      - (ii) [State](/usc/42/619.md?p=5) criminal convictions related to the delivery of a health care item or service;
      - (iii) exclusion from participation in [State](/usc/42/619.md?p=5) health care programs (as defined in [section 1320a–7(h) of this title](/usc/42/1320a–7.md?p=h));
      - (iv) any licensing or certification action described in [subsection (a)(1)(A)](#a-1-A) taken against a supplier by a [State](/usc/42/619.md?p=5) licensing or certification [agency](/usc/42/1397n–12.md?p=1); and
      - (v) any other adjudicated actions or decisions that the [Secretary](/usc/42/1301.md?p=a-6) shall establish by regulation.
    - (B) **Exception—** Such term does not include any action with respect to a malpractice claim.
- (h) **Appropriate coordination—** In implementing this section, the [Secretary](/usc/42/1301.md?p=a-6) shall provide for the maximum appropriate coordination with part B of the Health Care Quality Improvement Act of 1986 ([42 U.S.C. 11131](/usc/42/11131.md) et seq.) and [section 1320a–7e of this title](/usc/42/1320a–7e.md).

## Footnotes

[^1]: So in original. The semicolon probably should be a comma.
[^2]: So in original. Probably should be “to quality improvement organizations”.
[^3]: See References in Text note below.

## Source credit

(Aug. 14, 1935, ch. 531, title XIX, § 1921, as added Pub. L. 100–93, § 5(b), Aug. 18, 1987, 101 Stat. 690; amended Pub. L. 101–508, title IV, § 4752(f)(1), Nov. 5, 1990, 104 Stat. 1388–208; Pub. L. 111–148, title VI, § 6403(b), Mar. 23, 2010, 124 Stat. 764.)

## Notes

### Editorial Notes

### References in Text

Section 1320c–3(a)(4)(C) of this title, referred to in subsec. (b)(4), was repealed by Pub. L. 112–40, title II, § 261(c)(2)(A)(ii), Oct. 21, 2011, 125 Stat. 425.

The Health Care Quality Improvement Act of 1986 and that Act, referred to in subsecs. (b)(6) and (h), are title IV of Pub. L. 99–660, Nov. 14, 1986, 100 Stat. 3784, which is classified generally to chapter 117 (§ 11101 et seq.) of this title. Part B of the Act is classified generally to subchapter II (§ 11131 et seq.) of chapter 117 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 11101 of this title and Tables.

### Prior Provisions

A prior section 1921 of act Aug. 14, 1935, was renumbered section 1939 and is classified to section 1396v of this title.

### Amendments

2010—Subsec. (a)(1). Pub. L. 111–148, § 6403(b)(1)(A)(ii), redesignated subpars. (A) to (D) as cls. (i) to (iv), respectively, of subpar. (A).

Pub. L. 111–148, § 6403(b)(1)(A)(i), which directed adding subpar. (A) and striking out “The State” and all that follows through the “semicolon”, was executed by adding subpar. (A) and striking out “The State must have in effect a system of reporting the following information with respect to formal proceedings (as defined by the Secretary in regulations) concluded against a health care practitioner or entity by any authority of the State (or of a political subdivision thereof) responsible for the licensing of health care practitioners (or any peer review organization or private accreditation entity reviewing the services provided by health care practitioners) or entities:”, to reflect the probable intent of Congress.

Subsec. (a)(1)(A)(iii). Pub. L. 111–148, § 6403(b)(1)(A)(iii), substituted “license or the right to apply for, or renew, a license by” for “the license of” and inserted “nonrenewability,” after “voluntary surrender,”.

Subsec. (a)(1)(B). Pub. L. 111–148, § 6403(b)(1)(A)(iv), added subpar. (B).

Subsec. (a)(2). Pub. L. 111–148, § 6403(b)(1)(B), substituted “a State licensing or certification agency or State law or fraud enforcement agency” for “the authority described in paragraph (1)”.

Subsec. (b)(2). Pub. L. 111–148, § 6403(b)(2)(A), added par. (2) and struck out former par. (2) which read as follows: “to licensing authorities described in subsection (a)(1) of this section,”.

Subsec. (b)(4). Pub. L. 111–148, § 6403(b)(2)(B), inserted “, but only with respect to information provided pursuant to subsection (a)(1)(A)” before comma at end.

Subsec. (b)(5). Pub. L. 111–148, § 6403(b)(2)(C), added par. (5) and struck out former par. (5) which read as follows: “to State medicaid fraud control units (as defined in section 1396b(q) of this title),”.

Subsec. (b)(6). Pub. L. 111–148, § 6403(b)(2)(B), inserted “, but only with respect to information provided pursuant to subsection (a)(1)(A)” before comma at end.

Subsec. (b)(7) to (9). Pub. L. 111–148, § 6403(b)(2)(D), (E), added par. (7) and redesignated former pars. (7) and (8) as (8) and (9), respectively.

Subsecs. (d) to (g). Pub. L. 111–148, § 6403(b)(3), added subsecs. (d) to (g). Former subsec. (d) redesignated (h).

Subsec. (h). Pub. L. 111–148, § 6403(b)(3), (4), redesignated subsec. (d) as (h) and substituted “In implementing this section, the Secretary shall provide for the maximum appropriate coordination with part B of the Health Care Quality Improvement Act of 1986 (42 U.S.C. 11131 et seq.) and section 1320a–7e of this title.” for “The Secretary shall provide for the maximum appropriate coordination in the implementation of subsection (a) of this section and section 422 of the Health Care Quality Improvement Act of 1986.”

1990—Subsec. (a)(1). Pub. L. 101–508, § 4752(f)(1)(A), inserted “(or any peer review organization or private accreditation entity reviewing the services provided by health care practitioners)” after “health care practitioners” in introductory provisions.

Subsec. (a)(1)(D). Pub. L. 101–508, § 4752(f)(1)(B), added subpar. (D).

### Statutory Notes and Related Subsidiaries

### Effective Date of 2010 Amendment

Amendment by Pub. L. 111–148 effective on the first day after the final day of the transition period defined in section 6403(d)(5) of Pub. L. 111–148, see section 6403(d)(6) of Pub. L. 111–148, set out as a Transition Process; Regulations; Effective Date of 2010 Amendment note under section 1320a–7e of this title.

### Effective Date of 1990 Amendment

Pub. L. 101–508, title IV, § 4752(f)(2), Nov. 5, 1990, 104 Stat. 1388– 208, provided that: “The amendments made by paragraph (1) [amending this section] shall apply to State information reporting systems as of January 1, 1992, without regard to whether or not the Secretary of Health and Human Services has promulgated any regulations to carry out such amendments by such date.”

### Effective Date

Section applicable, with certain exceptions, to payments under subchapter XIX of this chapter for calendar quarters beginning more than thirty days after Aug. 18, 1987, without regard to whether or not final regulations to carry out this section have been published by that date, see section 15(c)(1), (2) of Pub. L. 100–93 set out as an Effective Date of 1987 Amendment note under section 1320a–7 of this title.