Legal & Ethical Standards in Healthcare Flashcards

How often must a hospital query the NPDB for each practitioner holding clinical privileges, at minimum?

Answer: At initial appointment and every 2 years at reappointment

Hospitals must query the NPDB when granting privileges and at least every two years thereafter.

If a hospital fails to query the NPDB as required, a court is likely to presume that the hospital:

Answer: Had knowledge of any information reported to the NPDB

Hospitals that fail to query are presumed to have knowledge of the information that would have been obtained.

Which law requires an organization to obtain the applicant's written authorization before obtaining a consumer report for a background check from a third-party agency?

Answer: Fair Credit Reporting Act (FCRA)

The FCRA requires disclosure and written consent before procuring consumer reports through a reporting agency.

Under the ADA, which question is generally inappropriate on a privileging application?

Answer: Have you ever been diagnosed with any mental health condition?

Broad questions about past diagnoses are discouraged; inquiries should focus on current ability to safely perform privileges.

Which element is required by HCQIA for a professional review action to qualify for immunity?

Answer: Adequate notice and hearing procedures afforded to the physician

HCQIA requires reasonable belief, reasonable fact-finding, adequate notice and hearing, and reasonable belief the action was warranted.

Which is the best example of 'economic credentialing'?

Answer: Denying reappointment because a physician refers patients to a competing facility

Economic credentialing uses financial factors unrelated to quality, such as referral patterns, to make privileging decisions.

Payments made on behalf of a practitioner to settle a malpractice claim must be reported to the NPDB within:

Answer: 30 days

Medical malpractice payment reports must be submitted to the NPDB within 30 days of payment.