CHCS Regulatory Compliance & Accreditation 2

Question 1

Under NCQA standards, how often must a health plan recredential its contracted practitioners?

Accepted Answer

Every 36 months

Answer

NCQA requires recredentialing at least every 36 months.

Question 2

Which federal law grants peer review bodies limited immunity from damages when they meet specific due-process standards?

Accepted Answer

Health Care Quality Improvement Act of 1986

Answer

HCQIA provides immunity for professional review actions that meet its four standards and also created the NPDB.

Question 3

Under HCQIA, how often must a hospital query the NPDB for practitioners already on its medical staff?

Accepted Answer

At least every two years

Answer

Hospitals must query the NPDB at initial appointment and at least every two years thereafter.

Question 4

Within how many days must an entity report a medical malpractice payment to the NPDB?

Accepted Answer

30 days

Answer

Malpractice payments must be reported to the NPDB within 30 days of the payment.

Question 5

A hospital restricts a physician's clinical privileges for 45 days after a professional review action. What is the NPDB reporting obligation?

Accepted Answer

A report is required because the restriction exceeds 30 days

Answer

Adverse privilege actions lasting more than 30 days based on competence or conduct must be reported to the NPDB.

CHCS - Certified Healthcare Credentialing Specialist Practice Test