CPMSM Ultimate Study Set 03 2019 updated to pass

CPMSM Ultimate Study Set 03 2019NPDB - correct answer National Practitioner Databank NPDB Contains: (what type of info) - correct answer - adverse licensure - clinical privilege actions - membership actions (professional/society) - paid malpractice judgements - exclusions from Medicare/Medicaid - actions by US DEA What must Hospitals and Other Health Care Entities report on for Physicians & Dentists (3 things), and how quickly must it be reported? - correct answer - Professional review actions based on competence, conduct, affecting privs >30 days - voluntary surrender/restriction of privs - to avoid investigation Must be submitted to NPDB and State licensing board within 15 days of action Who are entities that MUST report Physicians & Dentists to NPDB: (5 entities) - correct answer - Medical malpractice payers - State licensing board - Hospitals and other Health Care Entity - Professional society - HHS OIG Who are entities that MUST report Other Healthcare Practitioners to NPDB: (4 entities) - correct answer - Medical malpractice payers - Hospitals and other Health Care Entity (optional) - Professional society (optional) - HHS OIG Per Federal Law, NPDB info must be available to: (6) - correct answer - hospitals and healthcare entities - professional societies - state licensing auth - healthcare practitioner (self-query) - researchers (statistics only) - plaintiff attorneys (limited circumstance) Section 1921 of Social Security Act - what did it create? - Why was it created? - What does it do? - correct answer Medicare & Medicaid Patient and Program Protection Act To protect beneficiaries from fraud and abuse Expanded licensure and actions taken against all licensed healthcare practitioners Continuous Query was previously referred to as... - correct answer Previously - Proactive Disclosure Service (PDS) Continuous Query is accepted by which 3 accrediting agencies? - correct answer Accepted by TJC, CMS, NCQA When was the NPDB created? Who was NPDB created by? - correct answer -1986 -Established by Congress in