What does HCQIA stand for? - correct answer Health Care Quality Improvement Act
When was HCQIA enacted by congress? - correct answer 1986
What is
... [Show More] the purpose of HCQIA? - correct answer HCQIA was enacted to created a national tracking system of physicians with a history of medical malpractice payments or adverse actions.
What system was developed as a result of HCQIA? - correct answer The National Practitioner Databank (NPDB)
What does HCQIA protect? - correct answer The review of physicians and dentists. The review of allied health professionals is NOT protected by the HCQIA.
HCQIA of 1986 statute was enacted as a result of what case? - correct answer Patrick vs. Burgett: a federal antitrust case in which physicians were held liable for damages caused to Dr. Patrick by abusive and inappropriate peer review.
In order to qualify for HCQIA standards
of immunity a good faith peer review must what? - correct answer 1. Be carried out with the reasonable belief that the action was taken to further quality healthcare
2. Follow a reasonable effort, through investigation and review, to obtain the facts
3. Meet adequate notice and fair hearing procedures afforded to the physician or dentist, either by proving in court that the procedure was fair or by meeting fair hearing standards listed in
the HCQIA (see below)
4. Have been conducted in the reasonable belief that the action was warranted by the facts after
#2 (fact-finding) and #3 (fair hearing) are accomplished.
Who is HCQIA community coverage available to? - correct answer 1. Professional review bodies - Medical staffs are examples of professional review bodies.
2. Members and/or staff of those bodies - The individual members and medical staff
coordinators and credentialing specialists should qualify for protection under this section.
3. Those under contract with the bodies - Peer review consultants contracting to provide
impartial review should be protected under this section.
4. Anyone who participates or assists the bodies with respect to action.
5. Those who provide information regarding competence/conduct unless the information is false and the person giving the information knew it was false. Whistle blowers are protected under
this section.
What are the exceptions to HCQIA immunity coverage? - correct answer 1. Healthcare entities failing to meet the standards for immunity.
2. Healthcare entities failing to report information to the National Practitioner Data Bank. The
federal Health and Human Services Department would determine whether a hospital or
healthcare entity failed to report as required, and could take away the immunity protection
for up to three years.
What is a professional review BODY under HCQIA? - correct answer A health care entity, a governing body, any health care entity committee which conducts professional review actions, and any medical staff committee when it assists as the governing body in a professional review activity. [Show Less]