CPRP Credentialing, Compliance, and Legal Questions and Answers

Question 1

A hospital is recruiting a physician who currently practices in another state.
The physician holds a medical license and a DEA registration in their current state.
To legally prescribe controlled substances at the new hospital, what must the physician do regarding their DEA registration?

Accepted Answer

Obtain a new, separate DEA registration for the state in which the new hospital is located.

Answer

Transfer their existing DEA registration to the new practice address.

Answer

Use their current DEA registration, as it is a federal credential valid in any state.

Answer

Apply for a temporary waiver from the DEA to prescribe while the new state license is pending.

Question 2

A hospital must report an adverse action against a physician's clinical privileges to the National Practitioner Data Bank (NPDB). Which of the following scenarios would trigger this mandatory reporting requirement?

Accepted Answer

A professional review action that restricts the physician's privileges for more than 30 days.

Answer

A 20-day precautionary suspension of privileges pending a peer review investigation.

Answer

A letter of counseling issued to the physician regarding their charting habits.

Answer

The physician voluntarily resigns from the medical staff for personal reasons unrelated to any investigation.

Question 3

What was the primary purpose for the enactment of the Health Care Quality Improvement Act of 1986 (HCQIA)?

Accepted Answer

To provide legal immunity for good-faith peer review activities and establish the National Practitioner Data Bank.

Answer

To establish national standards for physician compensation and fair market value.

Answer

To regulate the use of telemedicine and electronic health records across state lines.

Answer

To create the federal Anti-Kickback Statute and define safe harbors for physician recruitment.

Question 4

A hospital enters into a Corporate Integrity Agreement (CIA) with the Office of Inspector General (OIG). Which of the following is a core obligation the hospital must undertake as part of the CIA?

Accepted Answer

Reduce its physician recruitment incentives by 50% for the duration of the agreement.

Answer

Divest from all physician-owned distributorships within one year.

Answer

Merge its compliance department with the legal department.

Answer

Prohibit the employment of individuals excluded from federal healthcare programs.

Question 5

Which of the following is a key distinction between the federal Anti-Kickback Statute (AKS) and the Stark Law?

Accepted Answer

The AKS requires proof of specific intent to induce referrals, whereas the Stark Law is a strict liability statute.

Answer

The Stark Law applies only to hospital-physician relationships, while the AKS applies to all healthcare providers.

Answer

Violations of the Stark Law carry criminal penalties, while AKS violations are purely civil.

Answer

The AKS pertains only to designated health services (DHS), while the Stark Law covers any service paid for by federal programs.

Question 6

Under the Stark Law's physician recruitment exception, a hospital can provide financial incentives to a physician joining a local private practice. What is a critical requirement for this arrangement to be compliant?

Accepted Answer

The arrangement must be set forth in a written agreement and the remuneration cannot be based on the volume or value of anticipated referrals.

Answer

The recruited physician must refer at least 50% of their patients to the recruiting hospital.

Answer

The financial assistance must be structured as a loan with a market-rate interest.

Answer

The physician must agree to serve on a hospital committee for a minimum of two years.