Screening

Question 1

Who should you sanction screen?

Answer 1

Employees, physicians, contractors, vendors and agents

Question 2

Name two sources you should review when conducting sanction screening.

Answer 2

OIG list of excluded individuals and GSA list of debarred contractors

Question 3

True/False: Compliance obligations should be included in role descriptions.

Answer 3

TRUE

Question 4

True/False: Compliance accountabilities should be included in performance evaluations.

Answer 4

TRUE

Question 5

True/False: Compliance questions should be asked during exit interviews.

Answer 5

TRUE

Question 6

What should you check before conducting background checks on individuals?

Answer 6

State and federal laws governing requirements for background checking

Question 7

Name some laws that govern background checks.

Answer 7

Consumer Credit Reporting Act (Fair Credit Reporting Act)

Fair and Accurate Credit Transaction Act

Question 8

What rights does an individual have when discrepancies are discovered?

Answer 8

Right to discuss and resolve any discrepancy
Right to request another investigation or present clarifying information if a third party was used to conduct the investigation

Question 9

Should organizations establish policies for background investigations for internal transfers and promotions?

Answer 9

Yes, when the employee is being promoted to management, into a corporate position or into a patient care position.

Question 10

What type of background investigation should be conducted on vendors and contractors supplying goods and services to an organization?

Answer 10

Reference checks, OIG/GSA sanction screeing, site visits

Question 11

What is the effect of an OIG exclusion?

Answer 11

No federal health care program payment may be made for any items or services (1) furnished by an excluded individual or entity or (2) directed or prescribed by an excluded physician

Question 12

True/False: Negligent credentialing could result in legal liability

Answer 12

TRUE

Question 13

What is the name of the independent, not for profit organization whose primary purpose is to provide voluntary accreditation to hospitals?

Answer 13

Joint Commission on Accreditation of Hospitals (JCAH)

Question 14

True/False: Hospitals accredited by JCAH are “deemed” to be in compliance with most of the Medicare Conditions of Participation for Hospitals

Answer 14

TRUE

Question 15

Name 3 key components of the Health Care Quality Improvement Act

Answer 15

1) immunity for peer review
2) establishment of National Practioner Data Bank
3) medical staff credentialing

Question 16

What law made credentialing of providers mandatory upon application and recredentialing every three years

Answer 16

Medicare Prescription Drug, Improvement and Modernization Act of 2003

Question 17

What is a Corporate Integrity Agreement?

Answer 17

A government imposed best practices agreement for organizations that violate guidelines and regulatory laws.