CPMSM EXAM QUESTIONS AND
ANSWERS 100% ACCURATE
HFAP stands for? - ANSWER-Healthcare Facilities Accreditation Program (Accrediting
organization for AOA. Provides accreditation programs for primarily osteopathic
hospitals)
The following bodies approves clinical privileges? - ANSWER-Governing Body or Board
Which NCQA-required committee makes recommendations regarding credentialing
decisions? - ANSWER-Credentialing Committee
What primary source verification is required by NCQA prior to temporary
privileges/provisional credentialing? - ANSWER-Licensure and 5 year history of
malpractice history
EMTALA stands for? - ANSWER-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
This accreditation has a 3 phase process to credentialing? - ANSWER-AAAHC
(establish training/experience, establish a process to review, carries out review)
Identity of the applicant must be verified for this accredition? - ANSWER-TJC
AAAHC stands for? - ANSWER-Accreditation Association for Ambulatory Healthcare
(Ambulatory Care Facilities)
AHRQ stands for? - ANSWER-Agency for Healthcare Research and Quality (est. in
1989)
Common Law is derived from? - ANSWER-The judicial decisions rather than statutes
HCQIA stands for? - ANSWER-Healthcare Quality Improvement Act of 1986
Name the federal law that was entailed for the purpose of encouraging good faith
professional review activities? - ANSWER-HCQIA of 1986
PSQIA stands for? - ANSWER-Patient Safety and Quality Improvement Act of 2005
Patrick vs. Burget case is a violation of and let to develop what Healthcare Regulatory?
- ANSWER-The Federal Anti-trust Laws (Anticompetitive Peer Review - Led to
development of HCQIA)
, NCQA & URAC counts the recredentialing period to the month or day? - ANSWER-
Month
Medicare COP's stands for? - ANSWER-Medicare Conditions of Participation
According to TJC the following is an element of a self-governing medical staff? -
ANSWER-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? - ANSWER-Parliamentary procedure
What are the three major sources of authority in the traditional structure of the hospital
organization? - ANSWER-CEO, Governing Body and Medical Staff
Governing boards may be generally classed into which two types? - ANSWER-
Philanthropic or Corporate
Nonfeasance difination? - ANSWER-Failure to act when there is a duty to do so
Negligent Tort has 4 elements, what are they? - ANSWER-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
Adverse action reports must be sent to state licensing boards within how many days? -
ANSWER-15
Divided into 4 standards/rules. privacy, security, identifiers, and transactions/code sets.
- ANSWER-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. - ANSWER-Stark Law
Misfeasance difination? - ANSWER-Doing a proper act in an unlawful or injurious
manner
According to AAAHC how often does the governing board meet? - ANSWER-The
governing body must meet at least annually
Felony convictions/criminal convictions information must be provided according to these
3 accreditations? - ANSWER-NCQA, HFAP & AAAHC
This accredition must perform an assessment of the capability and quality of the CVO's
work in order to use it? - ANSWER-AAAHC
ANSWERS 100% ACCURATE
HFAP stands for? - ANSWER-Healthcare Facilities Accreditation Program (Accrediting
organization for AOA. Provides accreditation programs for primarily osteopathic
hospitals)
The following bodies approves clinical privileges? - ANSWER-Governing Body or Board
Which NCQA-required committee makes recommendations regarding credentialing
decisions? - ANSWER-Credentialing Committee
What primary source verification is required by NCQA prior to temporary
privileges/provisional credentialing? - ANSWER-Licensure and 5 year history of
malpractice history
EMTALA stands for? - ANSWER-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
This accreditation has a 3 phase process to credentialing? - ANSWER-AAAHC
(establish training/experience, establish a process to review, carries out review)
Identity of the applicant must be verified for this accredition? - ANSWER-TJC
AAAHC stands for? - ANSWER-Accreditation Association for Ambulatory Healthcare
(Ambulatory Care Facilities)
AHRQ stands for? - ANSWER-Agency for Healthcare Research and Quality (est. in
1989)
Common Law is derived from? - ANSWER-The judicial decisions rather than statutes
HCQIA stands for? - ANSWER-Healthcare Quality Improvement Act of 1986
Name the federal law that was entailed for the purpose of encouraging good faith
professional review activities? - ANSWER-HCQIA of 1986
PSQIA stands for? - ANSWER-Patient Safety and Quality Improvement Act of 2005
Patrick vs. Burget case is a violation of and let to develop what Healthcare Regulatory?
- ANSWER-The Federal Anti-trust Laws (Anticompetitive Peer Review - Led to
development of HCQIA)
, NCQA & URAC counts the recredentialing period to the month or day? - ANSWER-
Month
Medicare COP's stands for? - ANSWER-Medicare Conditions of Participation
According to TJC the following is an element of a self-governing medical staff? -
ANSWER-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? - ANSWER-Parliamentary procedure
What are the three major sources of authority in the traditional structure of the hospital
organization? - ANSWER-CEO, Governing Body and Medical Staff
Governing boards may be generally classed into which two types? - ANSWER-
Philanthropic or Corporate
Nonfeasance difination? - ANSWER-Failure to act when there is a duty to do so
Negligent Tort has 4 elements, what are they? - ANSWER-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
Adverse action reports must be sent to state licensing boards within how many days? -
ANSWER-15
Divided into 4 standards/rules. privacy, security, identifiers, and transactions/code sets.
- ANSWER-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. - ANSWER-Stark Law
Misfeasance difination? - ANSWER-Doing a proper act in an unlawful or injurious
manner
According to AAAHC how often does the governing board meet? - ANSWER-The
governing body must meet at least annually
Felony convictions/criminal convictions information must be provided according to these
3 accreditations? - ANSWER-NCQA, HFAP & AAAHC
This accredition must perform an assessment of the capability and quality of the CVO's
work in order to use it? - ANSWER-AAAHC
