Cpmsm Practice Test Part I Of II
.
- 1.Why it is important to check that the practitioner is not currently excluded, suspended, debarred, or ineligible to participate in Federal health care programs?
- A.
A facility could lose its accreditation if it does not do so.
- B.
It is required by Medicare Conditions of Participation.
- C.
The facility won't get paid for treating patients unless service is provided by authorized provider.
- D.
It would violate state licensure regulations.
- 2.Which of the following credentials must be tracked on an ongoing basis?
- A.
Medical school completion
- B.
Post graduate education completed
- C.
Closed medical malpractice claims
- D.
Licensure
- 3.According to NCQA standards, an organization that discovers sanction information, complaints, or adverse events regarding a practitioner must take what action?
- A.
Determine it there is evidence of poor quality that could affect the health and safety of its members.
- B.
Immediately take action to remove the provider from its panel
- C.
Initiate Ongoing Professional Practice Evaluation.
- D.
Notify the practitioner that he/she is under investigation and initiate the hearing process.
- 4.What is the name of the entity that was established through the Health Care Quality Improvement Act of 1986 to restrict the ability of incompetent physicians, dentists, and other health care practitioners to move from state to state without disclosure or discovery of previous medical malpractice payment and adverse action history?
- A.
Emergency Medical Treatment and Active Labor Act
- B.
The National Practitioner Data Bank
- C.
The Patient Safety and Quality Improvement Act
- D.
Sherman Anti-trust Act
- 5.When developing clinical privileging criteria, which of the following is important to evaluate?
- A.
How many providers are in the specialty.
- B.
Established standards of practice such as, specialty board recommendations.
- C.
Whether or not the quality department can support the FPPE process.
- D.
The average cost to the patient.
- 6.What is the main reason for periodically assessing appropriateness of clinical privileges for each specialty?
- A.
It's required by accreditation standards.
- B.
It is required by the Medicare Conditions of Participation
- C.
To protect patient safety by ensuring current competency, relevance to the facility, and accepted standards of care.
- D.
It's required by bylaws.
- 7.Which of the following specialists is most likely to perform a PTCA?
- A.
General Surgeon
- B.
OB/GYN
- C.
Urologist
- D.
Interventional Cardiologist
- 8.The Joint Commission hospital standards require that clinical privileges are hospital-specific and
- A.
Based on the individual's demonstrated current competence and the procedures the hospital can support.
- B.
Based on board certification
- C.
Based on the privileges the individual is currently approved to perform at other hospitals
- D.
Posted in a place that is accessible to all hospital employees
- 9.Which of the following would be routinely performed by a cardiologist?
- A.
Hysterectomy
- B.
Transesophageal Echocardiography
- C.
Urethral Dilation
- D.
Renal dialysis
- 10.Which NCQA-required committee makes recommendations regarding credentialing decisions?
- A.
Medical Executive Committee
- B.
Quality Care Committee
- C.
Credentialing Committee
- D.
Patient Care Committee
- 11.HFAP standards require three medical staff committee to be delineated in the medical staff structure. Two of them are the Medical Executive Committee and the Utilization of Osteopathic Methods & Concepts Committee ( required for hospitals with ten or more DO's who admit patients and provide direct patient care). What is the other required medical staff committee?
- A.
Credentials Committee
- B.
Investigational Review Board
- C.
Utilization Review Committee
- D.
Medical Records Committee
- 12.If you need to find out about what the Federal Government requires in regards to anti-trust issues, what law would you consult?
- A.
Healthcare Quality Improvement Act
- B.
Patient Safety and Quality Improvement Act
- C.
Medicare Conditions of Participation
- D.
Sherman Anti-trust Act
- 13.Peer references should be obtained from:
- A.
Practitioners who have referred patients to the provider
- B.
Family, friends and neighbors
- C.
Former hospital administrators
- D.
Practitioners in the same professional discipline as the applicant
- 14.Patrick v. Burgett is an important case because it:
- A.
Showed that a hospital can assert that peer review is performed at the state's request
- B.
Illustrates that the governing body is the ultimate authority
- C.
Set aside the charitable immunity doctrine and held that the hospital was liable for negligent treatment of the patient
- D.
Illustrates the potential for antitrust liability arising out of the peer review activities
- 15.If a medical staff member has privileges and/or medical staff appointment revoked he/she must be:
- A.
Granted temporary privileges
- B.
Provided due process
- C.
Reported immediately to the national practitioner data bank
- D.
Offered a leave of absence from the medical staff
- 16.Access to the credentials files should be:
- A.
Available to all members of the organization's staff
- B.
Described fully in an access policy
- C.
Available to the organization's patients and potential patients
- D.
Available to any physician on the staff
- 17.Which of the following bodies approves clinical privileges?
- A.
Credentials Committee
- B.
Peer Review Committee
- C.
Medical Executive Committee
- D.
Governing Body or Board
- 18.What primary source verification is required by NCQA prior to provisional credentialing?
- A.
Current competence
- B.
Licensure and 5 year malpractice history of NPDB
- C.
Education and Training
- D.
Ability to perform privileges requested
- 19.According to The Joint Commission standards, initial appointments to the medical staff are made for a period of:
- A.
One year
- B.
Two years
- C.
Three years
- D.
Not to exceed two years
- 20.According to The Joint Commission standards, temporary privileges may be granted by:
- A.
The department chair
- B.
The CEO
- C.
The CEO on the recommendation of the medical staff president or authorized designee
- D.
The department chair and the president of the medical staff
- 21.According to The Joint Commission standards, which of the following items must be verified with a primary source?
- A.
Medicare/Medicaid Sanctions
- B.
Proof of professional liability insurance
- C.
Licensure, training, experience, and competence
- D.
Date of the last hepatitis test
- 22.According to NCQA standards, a copy of which of the following is acceptable verification of the document?
- A.
DEA certificate
- B.
Licensure
- C.
Board certification
- D.
Medical school diploma
- 23.According to NCQA standards, which is an acceptable source for primary source verification of Medicare and Medicaid sanction activity against physicians?
- A.
Federation of State Medical Boards
- B.
American Board of Medical Specialties
- C.
Education Commission on Foreign Medical Graduates Profile
- D.
Letter from the State licensing agency
- 24.According to The Joint Commission standards, which of the following is considered a designated equivalent source for verification of board certification?
- A.
The American Board of Medical Specialties
- B.
Education Commission on Foreign Medical Graduates Profile
- C.
Federation of State Medical Boards
- D.
Viewing of the original certificate issued by the certifying board
- 25.Which of the following organizations have been recognized by The Joint Commission and NCQA to provide primary source verification of medical school graduation and residency training for U.S. graduates?
- A.
American Medical Association Masterfile
- B.
National Practitioner Data Bank
- C.
Federation of State Medical Boards
- D.
Education Commission on Foreign Medical Graduates Profile
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