CPMSM EXAM QUESTIONS AND ANSWERS
HFAP stands for? - Answers :Healthcare Facilities Accreditation Program (Accrediting
organization for AOA. Provides accreditation programs for primarily osteopathic
hospitals)
The following bodies approves clinical privileges? - Answers :Governing Body or Board
Which NCQA-required committee makes recommendations regarding credentialing
decisions? - Answers :Credentialing Committee
What primary source verification is required by NCQA prior to temporary
privileges/provisional credentialing? - Answers :Licensure and 5 year history of
malpractice history
EMTALA stands for? - Answers :Emergency Treatment and Active Labor Act (anti-
dumping) which was enacted to stop hospitals from transferring, discharging or refusing
to treat indigent patients coming to the ED because of cost factors
Divided into 4 standards/rules. privacy, security, identifiers, and transactions/code sets.
- Answers :HIPAA
Prohibits a physician who has a financial relationship with an entity from referring a
medicare and Medicaid patients to that entity for the provision of a designated health
service. - Answers :Stark Law
HCQIA stands for? - Answers :Healthcare Quality Improvement Act of 1986
Name the federal law that was entailed for the purpose of encouraging good faith
professional review activities? - Answers :HCQIA of 1986
PSQIA stands for? - Answers :Patient Safety and Quality Improvement Act of 2005
Patrick vs. Burget case is a violation of and let to develop what Healthcare Regulatory?
- Answers :The Federal Anti-trust Laws (Anticompetitive Peer Review - Led to
development of HCQIA)
NCQA & URAC counts the recredentialing period to the month or day? - Answers
:Month
Medicare COP's stands for? - Answers :Medicare Conditions of Participation
According to TJC the following is an element of a self-governing medical staff? -
Answers :Medical Staff determines the mechanism for establishing and enforcing
criteria for assigning oversight responsibilities to practitioners with independent
privileges
, Roberts Rule of Order is an example of? - Answers :Parliamentary procedure
What are the three major sources of authority in the traditional structure of the hospital
organization? - Answers :CEO, Governing Body and Medical Staff
Governing boards may be generally classed into which two types? - Answers
:Philanthropic or Corporate
Nonfeasance difination? - Answers :Failure to act when there is a duty to do so
Negligent Tort has 4 elements, what are they? - Answers :1. Duty to exercise due care:
standard of care, 2. Breach of duty, 3. Injury (no injury - no liability), 4. Proximate
Cause: injury must be caused by breach of duty
Misfeasance difination? - Answers :Doing a proper act in an unlawful or injurious
manner
According to AAAHC how often does the governing board meet? - Answers :The
governing body must meet at least annually
Felony convictions/criminal convictions information must be provided according to these
3 accreditations? - Answers :NCQA, HFAP & AAAHC
This accredition must perform an assessment of the capability and quality of the CVO's
work in order to use it? - Answers :AAAHC
Reappointment not to exceed 3 years for these 3 accreditiation? - Answers :AAAHC,
NCQA, URAC
This accreditation has a 3 phase process to credentialing? - Answers :AAAHC
(establish training/experience, establish a process to review, carries out review)
Identity of the applicant must be verified for this accredition? - Answers :TJC
AAAHC stands for? - Answers :Accreditation Association for Ambulatory Healthcare
(Ambulatory Care Facilities)
AHRQ stands for? - Answers :Agency for Healthcare Research and Quality (est. in
1989)
Common Law is derived from? - Answers :The judicial decisions rather than statutes
Adverse action reports must be sent to state licensing boards within how many days? -
Answers :15
HFAP stands for? - Answers :Healthcare Facilities Accreditation Program (Accrediting
organization for AOA. Provides accreditation programs for primarily osteopathic
hospitals)
The following bodies approves clinical privileges? - Answers :Governing Body or Board
Which NCQA-required committee makes recommendations regarding credentialing
decisions? - Answers :Credentialing Committee
What primary source verification is required by NCQA prior to temporary
privileges/provisional credentialing? - Answers :Licensure and 5 year history of
malpractice history
EMTALA stands for? - Answers :Emergency Treatment and Active Labor Act (anti-
dumping) which was enacted to stop hospitals from transferring, discharging or refusing
to treat indigent patients coming to the ED because of cost factors
Divided into 4 standards/rules. privacy, security, identifiers, and transactions/code sets.
- Answers :HIPAA
Prohibits a physician who has a financial relationship with an entity from referring a
medicare and Medicaid patients to that entity for the provision of a designated health
service. - Answers :Stark Law
HCQIA stands for? - Answers :Healthcare Quality Improvement Act of 1986
Name the federal law that was entailed for the purpose of encouraging good faith
professional review activities? - Answers :HCQIA of 1986
PSQIA stands for? - Answers :Patient Safety and Quality Improvement Act of 2005
Patrick vs. Burget case is a violation of and let to develop what Healthcare Regulatory?
- Answers :The Federal Anti-trust Laws (Anticompetitive Peer Review - Led to
development of HCQIA)
NCQA & URAC counts the recredentialing period to the month or day? - Answers
:Month
Medicare COP's stands for? - Answers :Medicare Conditions of Participation
According to TJC the following is an element of a self-governing medical staff? -
Answers :Medical Staff determines the mechanism for establishing and enforcing
criteria for assigning oversight responsibilities to practitioners with independent
privileges
, Roberts Rule of Order is an example of? - Answers :Parliamentary procedure
What are the three major sources of authority in the traditional structure of the hospital
organization? - Answers :CEO, Governing Body and Medical Staff
Governing boards may be generally classed into which two types? - Answers
:Philanthropic or Corporate
Nonfeasance difination? - Answers :Failure to act when there is a duty to do so
Negligent Tort has 4 elements, what are they? - Answers :1. Duty to exercise due care:
standard of care, 2. Breach of duty, 3. Injury (no injury - no liability), 4. Proximate
Cause: injury must be caused by breach of duty
Misfeasance difination? - Answers :Doing a proper act in an unlawful or injurious
manner
According to AAAHC how often does the governing board meet? - Answers :The
governing body must meet at least annually
Felony convictions/criminal convictions information must be provided according to these
3 accreditations? - Answers :NCQA, HFAP & AAAHC
This accredition must perform an assessment of the capability and quality of the CVO's
work in order to use it? - Answers :AAAHC
Reappointment not to exceed 3 years for these 3 accreditiation? - Answers :AAAHC,
NCQA, URAC
This accreditation has a 3 phase process to credentialing? - Answers :AAAHC
(establish training/experience, establish a process to review, carries out review)
Identity of the applicant must be verified for this accredition? - Answers :TJC
AAAHC stands for? - Answers :Accreditation Association for Ambulatory Healthcare
(Ambulatory Care Facilities)
AHRQ stands for? - Answers :Agency for Healthcare Research and Quality (est. in
1989)
Common Law is derived from? - Answers :The judicial decisions rather than statutes
Adverse action reports must be sent to state licensing boards within how many days? -
Answers :15
