Free CPCS Negligent Credentialing and Legal Risk Management Questions and Answers

Question 1

What is the legal doctrine of 'negligent credentialing'?

Accepted Answer

An organization's failure in its duty to vet a practitioner, resulting in patient harm.

Answer

A practitioner's failure to obtain the correct credentials.

Answer

The act of denying credentials to a qualified practitioner without cause.

Answer

A clerical error made during the processing of a credentialing application.

Question 2

Which landmark court case established a hospital's corporate liability for the quality of care and its duty to properly oversee the credentialing of its physicians?

Accepted Answer

Darling v. Charleston Community Memorial Hospital

Answer

Roe v. Wade

Answer

Patrick v. Burget

Answer

Johnson v. Misericordia Community Hospital

Question 3

To mitigate the risk of negligent credentialing, the most critical practice is to:

Accepted Answer

Conduct primary source verification of all relevant credentials.

Answer

Accept photocopies of diplomas and licenses provided by the applicant.

Answer

Rely solely on the attestation statement signed by the practitioner.

Answer

Check the practitioner's social media profiles for unprofessional behavior.

Question 4

Which of the following is considered a significant 'red flag' on a credentialing application that requires further investigation to manage legal risk?

Accepted Answer

An unexplained gap in work history between two positions.

Answer

Graduation from a foreign medical school.

Answer

A high number of publications in medical journals.

Answer

Previous employment in a solo private practice.

Question 5

How does the Health Care Quality Improvement Act (HCQIA) of 1986 help organizations manage legal risk?

Accepted Answer

It provides legal immunity for good-faith peer review activities.

Answer

It mandates specific malpractice insurance limits for all physicians.

Answer

It requires all hospitals to use a standardized credentialing application form.

Answer

It funds the development of new credentialing software.

Question 6

A hospital's failure to query the National Practitioner Data Bank (NPDB) during the initial credentialing process could be used as evidence of:

Accepted Answer

Negligent credentialing.

Answer

A HIPAA violation.

Answer

Antitrust behavior.

Answer

A Stark Law violation.

Question 7

The 'corporate duty of care' in the context of credentialing refers to the organization's:

Accepted Answer

Independent responsibility to ensure practitioners are competent and qualified.

Answer

Responsibility to maximize profits for shareholders.

Answer

Duty to provide the latest medical technology.

Answer

Obligation to follow the recommendations of the medical staff without question.