Discipline

Question 1

The determination to take corrective action against a provider as a result of credentialing activities should be made by:

Answer 1

A review committee with legal, compliance and medical representation

Question 2

When should a provider be granted a hearing?

Answer 2

If corrective action or termination involves or results in termination or suspension of provider’s status and is reportable to the NPDB or limits the providers ability to perform certain procedures.

Question 3

When is a provider action generally not reviewable?

Answer 3

1) loss of licensure; or

2) federal or state sanction, exclusion or disbarment when one’s ability to practice is denied.

Question 4

Name 5 important points regarding discipline

Answer 4

1) discipline must be consistent
2) mechanisms for discipline must exist
3) plan of discipline for those who fail to detect an offense committed by someone else must exist
4) plan of discipline for those who commit offense must exist
5) punishment must be based on severity of infraction

Question 5

True/False: Written standards of conduct should include procedures for handling disciplinary problems and those who are responsible for taking appropriate action

Answer 5

TRUE

Question 6

True/False: The OIG dictates specific punishments organizations should take for identified infractions

Answer 6

FALSE. OIG provides a framework for reference that states that punishment “could range from oral warnings to suspension, termination or financial penalties, as appropriate.”

Question 7

True/False: The OIG strongly suggests that the promotion of and adherence to compliance should be taken into account during performance reviews

Answer 7

TRUE

Question 8

True/False: Managers and supervisors should be sanctioned for failure to investigate or detect non-compliance

Answer 8

TRUE

Question 9

How should an organization discipline agents and independent contractors for compliance violations?

Answer 9

terminate the relationship, stop doing business with the agent

Question 10

Before contracting with an agent, an organization should verify what?

Answer 10

That the agent has adopted a compliance plan that meets the minimum standards in the Federal Sentencing Guidelines

Question 11

What does the Whistle Blower Act prevent?

Answer 11

punishment or wrongful discharge of an employee who reports suspected wrongdoing.

Question 12

True/False: Organization should have written standards outlining typical violations and matching those to expected consequences.

Answer 12

TRUE