CPMSM Preparation Test
questions and answers 2025
latest update.
Why is it important to check that the practitioner is not
currently exclude, suspended, debarred, or ineligible to
participate in Federal health care programs? - answer
The facility will not get paid for treating patients unless
the service is provided by an authorized provider.
Which of the following credentials must be tracked on an
ongoing basis? - answer Licensure
According to NCQA standards, an organization that
discovers sanction information, complaints, or adverse
events regarding a practitioner must take what action? -
answer Determine if there is evidence of poor quality
that could affect the health and safety of its members.
What is the name of the entity that was established thru
the Health Care Quality Improvement Act of 1986 to
restrict the ability of incompetent physicians, dentists,
and other health care practitioners to move from state to
state without disclosure or discovery of previous medical
malpractice payment and adverse action history? - answer
The Nation Practitioner Data Bank
When developing clinical privileging criteria, which of the
following is important to evaluate? - answer Established
,standards of practice such as specialty board
recommendations.
What is the main reason for periodically assessing
appropriateness of clinical privileges for each specialty? -
answer To protect patient safety by ensuring current
competency, relevance to the facility, and accepted
standards of care.
Which of the following specialists is most likely to perform
a PTCA? - answer Interventional Cardiologist
The Joint Commission hospital standards require that
clinical privileges are hospital specific and - answer
Based on the individual's demonstrated current
competence and the procedures the hospital can support.
Which of the following would be routinely performed by a
cardiologist? - answer Transesophageal
Echocardiography
Which NCQA required committee makes recommendations
regarding credentialing decisions? - answer Credentialing
Committee
HFAP standards require three medical staff committees to
be delineated in the medical staff structure; what are
they? - answer Medical Executive Committee, the
Utilization Review Committee and the Utilization of
Osteopathic Methods and Concepts Committee
, If you needed to find out about what the federal
government requires in regards to anti-trust issues, what
law would you consult? - answer The Sherman Anti-trust
Act
Peer references should be obtained from: - answer
Practitioners in the same professional discipline as the
applicant.
Patrick v. Burgett is an important case because it: -
answer Illustrates the potential for antitrust liability
arising out of peer review activities.
If a medical staff member has privileges and / or medical
staff appointment revoked, he/she must be: - answer
Provided due process
Access to credentials files should be: - answer Described
fully in an access policy
Which of the following bodies approves clinical privileges?
- answer The Governing body / Board
Which primary source verification is required by NCQA
prior to provisional credentialing? - answer Licensure and
5 years of malpractice history or NPDB
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