Event-to-Payment Latency in Physicians With Imaging-Related Allegations: NPDB Reports Processed 2004-2025

To characterize event-to-payment/report-processing latency among physicians with imaging-related allegations.

This retrospective cross-sectional study included National Practitioner Data Bank physician payment reports processed in 2004-2025, excluding state-fund reports. Imaging-related allegations were identified in either specific-allegation field. Latency equaled original report-processing year minus alleged-event end year, using onset year when end year was unavailable. Adjusted models included report characteristics and jurisdiction, with practitioner-clustered standard errors. Complementary analyses examined events in 2004-2010 and jurisdiction random effects.

Among 199,060 eligible reports, 1,980 involved imaging-related allegations (1,852 physicians). Median latency was 4 years (IQR, 3-6); 47.0% had latency ≥5 years. The proportions were 43.7% (2004-2009), 42.9% (2010-2015), 46.1% (2016-2020), and 55.7% (2021-2025). Adjusted differences were +0.66 years for permanent injury and +0.48 for death versus nonpermanent injury; +0.38 for outpatient and +0.49 for mixed settings versus inpatient care; and +1.56 for judgment versus settlement/other. All corresponding 95% confidence intervals excluded zero. Age was associated with -0.16 years per decade-category increment. Among 562 reports for events in 2004-2010, median latency was 4 years and 44.1% had latency ≥5 years. The adjusted payment ratio per additional latency year was 1.021 (95% CI, 0.997-1.044; P=0.082).

Paid reports involving physicians with imaging-related allegations frequently reflected care delivered years earlier. The payment association was small, imprecise, and not statistically significant. These selected paid-report data do not estimate litigation duration, future payment risk, or radiologist-specific performance.