CPCS Medical Staff Governance 5

Question 1

A practitioner files a lawsuit claiming a hospital's peer review process violated the Health Care Quality Improvement Act (HCQIA). Under HCQIA, immunity from damages is available to peer reviewers if they meet which standard?

Accepted Answer

The review met the four HCQIA standards: reasonable belief, adequate notice, adequate hearing, and reasonable belief the action was warranted

Answer

HCQIA grants immunity when peer reviewers acted in the reasonable belief the action furthered quality care, provided adequate notice and hearing, and reasonably believed the action was warranted.

Question 2

An allied health professional (AHP) such as a nurse practitioner applies for clinical privileges at a hospital. Who is typically responsible for overseeing the AHP's practice?

Accepted Answer

A supervising or collaborating physician as defined by the medical staff bylaws

Answer

Medical staff bylaws typically require AHPs to practice under the supervision or collaboration of a physician member of the medical staff, as specified in the bylaws or policies.

Question 3

Which of the following situations would MOST likely require an immediate suspension of privileges without the standard fair hearing process?

Accepted Answer

A practitioner whose actions create an immediate threat to patient safety

Answer

Immediate suspension without prior hearing is justified only when a practitioner's continued practice poses an immediate threat to patient health or safety; due process follows the suspension.

Question 4

The term 'primary source verification' means that credentials are confirmed directly with which entity?

Accepted Answer

The original issuing institution, board, or agency

Answer

Primary source verification requires obtaining confirmation of credentials directly from the original source (e.g., medical school, licensing board, certifying board) rather than from the practitioner.

Question 5

Which of the following is an acceptable primary source for verifying a physician's medical school graduation?

Accepted Answer

Direct confirmation from the medical school's registrar

Answer

Only direct confirmation from the medical school's registrar qualifies as primary source verification of graduation; diplomas and third-party attestations are not acceptable.

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS Medical Staff Governance 5