CPHRM Basic CPHRM 4 — Questions and Answers
Question 1: The Health Care Quality Improvement Act (HCQIA) of 1986 provides immunity to peer review participants primarily to:
- Shield hospitals from malpractice liability
- Encourage good-faith reporting and action against incompetent practitioners (Correct answer)
- Protect patient records from subpoena
- Allow hospitals to deny staff privileges without explanation
Correct answer: Encourage good-faith reporting and action against incompetent practitioners
HCQIA grants qualified immunity to peer review participants acting in good faith to encourage frank assessment of physician competence.
Question 2: A risk manager reviewing surgical site infection rates is performing which type of risk management activity?
- Risk transfer
- Risk financing
- Risk identification and analysis (Correct answer)
- Loss control training
Correct answer: Risk identification and analysis
Reviewing infection rate data is a risk identification and analysis activity, used to recognize and evaluate potential loss exposures.
Question 3: Which federal statute protects whistleblowers who report Medicare and Medicaid fraud and abuse?
- HIPAA
- False Claims Act (qui tam provisions) (Correct answer)
- Stark Law
- Anti-Kickback Statute
Correct answer: False Claims Act (qui tam provisions)
The False Claims Act's qui tam provisions allow whistleblowers to file suit on behalf of the government and receive a portion of recovered funds.
Question 4: In the context of informed consent, 'therapeutic privilege' allows a provider to withhold information when:
- The patient requests less information
- Disclosure would cause serious psychological harm or prevent rational decision-making (Correct answer)
- The procedure is considered routine
- Family members request non-disclosure
Correct answer: Disclosure would cause serious psychological harm or prevent rational decision-making
Therapeutic privilege is a narrow exception permitting non-disclosure only when revealing information would seriously harm the patient or impair their ability to make a rational decision.
Question 5: Which risk management tool involves assigning numerical values to likelihood and impact to prioritize risks?
- Fishbone (Ishikawa) diagram
- Risk matrix or heat map (Correct answer)
- Failure mode and effects analysis
- Event timeline analysis
Correct answer: Risk matrix or heat map
A risk matrix or heat map plots risks by probability and severity to visually prioritize which risks need the most attention.
Question 6: An 'occurrence-based' malpractice policy covers claims arising from incidents that:
- Are reported during the active policy period, regardless of when they occurred
- Occurred during the policy period, regardless of when the claim is filed (Correct answer)
- Are filed within three years of policy inception
- Involve only employed physicians
Correct answer: Occurred during the policy period, regardless of when the claim is filed
Occurrence policies provide coverage for any incident that occurred during the policy period, even if the claim is made years later.
Question 7: Which principle of biomedical ethics requires healthcare providers to act in the patient's best interest?
- Autonomy
- Justice
- Beneficence (Correct answer)
- Non-maleficence
Correct answer: Beneficence
Beneficence obligates providers to act in ways that benefit the patient and promote their well-being.
CPHRM Basic CPHRM 4
The Health Care Quality Improvement Act (HCQIA) of 1986 provides immunity to peer review participants primarily to: