CPMSM STUDY SET
CPMSM STUDY SET WITH GUARANTEED ACCURATE ANSWERS |VERIFIED
NPDB - ACCURATE ANSWERS✔✔ National Practitioner Databank
NPDB Contains: (what type of info) - ACCURATE ANSWERS✔✔ -
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? -
,ACCURATE ANSWERS✔✔ - 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) - ACCURATE ANSWERS✔✔ - 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) - ACCURATE ANSWERS✔✔ - 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) - ACCURATE
ANSWERS✔✔ - 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? - ACCURATE ANSWERS✔✔ 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... - ACCURATE
ANSWERS✔✔ Previously - Proactive Disclosure Service (PDS)
Continuous Query is accepted by which 3 accrediting agencies? -
ACCURATE ANSWERS✔✔ Accepted by TJC, CMS, NCQA
When was the NPDB created?
Who was NPDB created by? - ACCURATE ANSWERS✔✔ -1986
, -Established by Congress in
What is the purpose of the NPDB? - ACCURATE ANSWERS✔✔ Tool
that prevents practitioners from moving state to state without disclosure
or discovery of previous damaging performance. Federal regulations
authorize eligible entities to report to and/or query the NPDB.
When did HIPDB and NPDB merge? - ACCURATE ANSWERS✔✔
2013
What is the NPDB Public Use Data File? - ACCURATE ANSWERS✔✔
Provides data to the public for statistical reporting and analysis; no
specific info is divulged about the practitioners or reporting entities.
Updated 4x per year
How quickly should an event be reported to the NPDB? - ACCURATE
ANSWERS✔✔ Within 30 days of the event
Is an event reportable to the NPDB if privileges are affected for 30 days
or less? - ACCURATE ANSWERS✔✔ No
Who maintains the NPDB? - ACCURATE ANSWERS✔✔ Health
Resources and Services Administration (HRSA)
CPMSM STUDY SET WITH GUARANTEED ACCURATE ANSWERS |VERIFIED
NPDB - ACCURATE ANSWERS✔✔ National Practitioner Databank
NPDB Contains: (what type of info) - ACCURATE ANSWERS✔✔ -
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? -
,ACCURATE ANSWERS✔✔ - 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) - ACCURATE ANSWERS✔✔ - 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) - ACCURATE ANSWERS✔✔ - 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) - ACCURATE
ANSWERS✔✔ - 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? - ACCURATE ANSWERS✔✔ 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... - ACCURATE
ANSWERS✔✔ Previously - Proactive Disclosure Service (PDS)
Continuous Query is accepted by which 3 accrediting agencies? -
ACCURATE ANSWERS✔✔ Accepted by TJC, CMS, NCQA
When was the NPDB created?
Who was NPDB created by? - ACCURATE ANSWERS✔✔ -1986
, -Established by Congress in
What is the purpose of the NPDB? - ACCURATE ANSWERS✔✔ Tool
that prevents practitioners from moving state to state without disclosure
or discovery of previous damaging performance. Federal regulations
authorize eligible entities to report to and/or query the NPDB.
When did HIPDB and NPDB merge? - ACCURATE ANSWERS✔✔
2013
What is the NPDB Public Use Data File? - ACCURATE ANSWERS✔✔
Provides data to the public for statistical reporting and analysis; no
specific info is divulged about the practitioners or reporting entities.
Updated 4x per year
How quickly should an event be reported to the NPDB? - ACCURATE
ANSWERS✔✔ Within 30 days of the event
Is an event reportable to the NPDB if privileges are affected for 30 days
or less? - ACCURATE ANSWERS✔✔ No
Who maintains the NPDB? - ACCURATE ANSWERS✔✔ Health
Resources and Services Administration (HRSA)
