American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) Practice Exam

These questions are part of the practice quiz. Start practicing

• What information does the National Practitioner Data Bank (NPDB) report?
• To ensure successful outcomes, infection control primarily targets?
• What are the standards set by HIPAA aimed at protecting?
• What is the primary goal of provider profiling according to the provided information?
• According to Philip Crosby, how can a company generate savings in terms of quality performance?
• What significant change occurred to PRO in 1982?
• What does “tail coverage” provide for insurance holders?
• What is the main purpose of Medicare Part D Integrity Contractors (MEDICS)?
• What is defined as impairment in a medical context?
• What is the primary purpose of the Health Care Integrity and Protection Data Bank (HIPDB)?
• What does the Safe Harbor provision allow for physicians in rural areas?
• Which act provides compensation for maritime workers?
• What is the main objective of QARI established in 1993?
• According to healthcare standards, which of the following is not one of the six major aims of healthcare?
• What does the "One Program Integrity - One PI" initiative provide?
• What does the Healthcare Quality Improvement Act (HCQIA) provide for peer review actions?
• What do Recovery Audit Contractors (RACs) aim to correct?
• Which program was created by the Deficit Reduction Act of 2006?
• Which of the following is NOT one of Deming's 7 deadly diseases?
• What was one noted failure of the Medicare Prescription Drug Act?
• What does quality assurance historically address?
• Which of the following describes a Health Savings Account (HSA)?
• Which initiative was designed to improve quality measurement and performance in Medicare and Medicaid?
• Which of the following is a physician's right during peer review according to HCQIA?
• What was the key feature of the QISMC when it was formed?
• What is the purpose of Demand Management in healthcare?
• What was one of the significant outcomes demonstrated by Project RED?
• What impact does the Affordable Care Act have on the number of uninsured individuals?
• What was the primary focus of the PRO peer review organization from 1972 to 1982?
• What type of data is noted as being highly accurate but also high in cost for profiling?
• What are some of Deming's 7 deadly diseases for organizations?
• In a malpractice lawsuit, what must be shown regarding the doctor’s actions?
• Which act established the MIP to address fraud?
• What is indicated by temporary disability?
• What is the primary purpose of an Accountable Care Organization (ACO)?
• Which term refers to errors that reveal their effects immediately?
• What was the primary focus of the National Transition of Care Coalition (NTOCC) when it was founded in 2006?
• What type of credentialing is based on the effectiveness of medical care with specific cost limits?
• What is the goal of comparative effectiveness research (CER)?
• What is the significance of the study titled "The Deep Sleep" broadcasted on 20/20 in 1982?
• What is the primary purpose of a Medical Savings Account (MSA)?
• What constitutes a permanent impairment?
• Quality management approaches emphasize which of the following?
• What does the Medicare Integrity Program (MIP) aim to address?
• What characterizes permanent disability?
• What is the primary purpose of the AAAHC accreditation?
• Who primarily benefits from MSAs?
• What is the time frame in which Medicare must pay or deny all claims?
• What initiative was launched by the Institute for Healthcare Improvement to focus on readmission rates?
• The College of American Pathologists (CAP) primarily focuses on which aspect of healthcare?
• What is the focus of Quality Management (QM)?
• Peer review involves which of the following?
• How much annual intervention cost is associated with the Transition of Care according to the provided information?
• What does the HCQIA 1986 stand for?
• How many basic principles of ethical practice are there for case management?
• What is one of the goals of the Affordable Care Act (ACA) implemented in March 2010?
• What is the primary goal of quality improvement?
• Why is it important for a physician to have malpractice insurance?
• What does quality assurance focus on?
• Utilization Review (UR) involves which of the following activities?
• Who is credited with the Plan-Do-Check-Act methodology?
• What distinguishes the CHAP accreditation from other healthcare accreditation bodies?
• What is the focus of the Patient Protection and Affordable Care Act?
• What is typically assessed during a peer review process?
• How are funds managed in a Flexible Spending Account (FSA)?
• What is a necessary component that must be proven in malpractice lawsuits?
• A primary focus of risk management includes?
• What aspect does privileges relate to in healthcare?
• What is the primary aim of Continuous Quality Improvement (CQI)?
• Which HMO model features a centralized facility and lower co-payment costs?
• According to the text, how frequently is the CNC updated?
• What is Medicare Advantage also known as?
• What type of data is known for being broadly available and used in profiling?
• What type of health plan is a Medical Savings Account paired with?
• CHAP is an accrediting body for which type of organizations?
• What is one of the expected outcomes of the HCQIA for physicians?
• Who is known for asserting that measurable outcomes are the best means to assess quality of care?
• Which type of health insurance allows for unrestricted provider choice but comes at a higher cost?
• What type of plan is a C-SNP?
• What is the goal of having multiple defenses in patient care, as suggested by the Swiss Cheese Model?
• Which principle of ethical practice means to keep your promise?
• How many beneficiaries' IDs were noted as compromised in the CNC?
• Which of the following is a characteristic of quality improvement?
• Which individual is known for introducing statistical processes to improve quality?
• What document led to comprehensive revisions of Medicaid federal statutes in 1997?
• What was the purpose of the PQRI introduced in 2006?
• What does the Compromised Number Checklist (CNC) monitor?
• What is a significant focus of the Malcolm Baldrige National Quality Award criteria?
• What does the HMO-POS model allow for in terms of provider choice?
• In what year did the HITECH Act come into effect?
• In a capitated payment arrangement, who bears the full financial risk?
• What does 'loss of life enjoyment' refer to in a compensation context?
• What must an effective ACO have to support its operations?
• Which evaluation technique is preferred during a Focused Professional Practice Evaluation (FPPE)?
• Under workers' compensation laws, what legal action can an injured worker take?
• What is meant by "maximum medical improvement" (MMI)?
• What does the Swiss Cheese Model illustrate in the context of patient safety?
• Which accrediting body is known for its involvement in rehabilitation services?
• According to the Stark Law, what is prohibited if a physician has a financial relationship with an entity?
• What issue does the Prospective Payment System (PPS) specifically address with regard to hospitals?
• What type of care is not covered under Medicare Advantage?
• What was the main aim of the H2H (Hospital to Home) initiative?
• What role did Dr. Lucian Leape play in healthcare safety?
• Which factor is critical to establish in a malpractice case related to the physician's performance?
• Credentialing in healthcare ensures what?
• What does the principle of non-malfeasance emphasize in healthcare practice?
• What type of compensation does the Jones Act provide for maritime workers?
• What was the main objective of Project RED (Project Re-Engineered Discharge)?
• What does the Center for Program Integrity (CPI) aim to integrate according to the text?
• Who founded the IHI in 1988, focusing on quality and safety?
• What is the ultimate responsibility for quality management in a hospital setting?
• What is the purpose of SCHIP?
• What is the main focus of the AAASF?
• Which act emphasized the importance of case management in healthcare?
• Total Quality Management (TQM) emphasizes which of the following components?
• What major legislation in 2009 aimed to promote meaningful use of health information technology?
• What was the founding year of the National Patient Safety Foundation (NPSF)?
• The HFEP stands for which healthcare accreditation program?
• What does HEIDS stand for?
• How is disability defined?
• What is a requirement to obtain Tricare for Life?
• What is the primary focus of Program Safeguard Contractors (PSCs)?
• How do organizations typically establish their own criteria for privileges?
• What does the Pre-Existing Condition Insurance Plan provide for individuals under 26 years old?
• What is the goal of Project BOOST?
• Which ethical principle involves treating all patients fairly?
• IAC is known for providing accreditation in which area?
• What significant contribution did Joseph Juran make to quality management?
• Which act aimed at improving prescription drug benefits and care coordination in 2003?
• Which principle relates to respecting a patient's right to make their own decisions?
• What does HIPAA primarily regulate?
• Which aspect does Risk Management focus on?
• How is quality defined in the context of service delivery?
• How are providers compensated in an Independent Practice Association (IPA)?
• Who is eligible for Tricare Prime?
• How many percent of Medicare payments are audited?
• What do beneficiaries have to pay under Tricare Extra and Tricare Standard?
• What does HEDIS stand for in healthcare quality measurement?
• Which organization structure requires patients to choose HMO doctors for care?
• What aspect of healthcare does the ACA primarily address?
• What strategy does the approach of Quality Improvement typically employ?
• What is the JC, or Joint Commission, recognized for in the United States?
• What is the typical outcome of a case heard under FELA?
• What statistic about adverse events in 1991 indicated a major concern?
• What is the primary purpose of a Transition of Care Nurse (TCN)?
• Which healthcare reform initiative focuses on Medicaid expansion to those below 138% of the poverty level?
• What is a major downside of the transactional system used for provider profiling?
• Which of the following is a common outcome of a malpractice lawsuit?
• What does the term "claims made" insurance signify?
• What role do Medicare Administrative Contractors (MACs) have under the MMA?
• Which legislation first created Medicare Advantage?
• What year was the Institute of Medicine (IOM) established?
• What does the Indian Health Services (IHS) primarily provide?
• Outcome studies are crucial for which purpose?
• The NCQA is a nonprofit organization focused on improving what aspect of healthcare?
• What is a characteristic of latent errors?
• What does quality management primarily examine?
• The primary goal of NCQA is to enhance healthcare through what means?
• In a capitated payment system, what is the financial liability of the enrollee?
• What organization was established to focus on improving patient safety specifically in anesthesia?
• Which of the following is a requirement for an ACO?
• What is a key feature of a Preferred Provider Organization (PPO)?
• A Sentinel Event is defined as which of the following?
• Infection Control primarily aims to?
• What does the Anti-Markup Rule prevent concerning Medicare diagnostic tests?
• What does the term 'reasonable effort to obtain facts' imply in the context of peer review?
• How does Tricare Extra differ from Tricare Prime?
• Which type of error is characterized by its immediate effects?
• What does the Federal Employers Liability Act (FELA) provide for injured workers?
• What year was the QISMC established, and what was its primary goal?
• Which act led to the creation of the QIO in 2002?
• What type of facilities does CARF accredit?
• What is the primary purpose of the PQRS system?
• What was the Medicare spending in 2013?
• What is the purpose of Root Cause Analysis?
• What is the purpose of occurrence malpractice insurance?
• What kind of savings can a Transition of Care Nurse achieve per patient?
• Among the following, which is NOT typically a focus in peer review processes?
• What is one advantage of Traditional Insurance compared to managed care plans?
• What does the Malcolm Baldrige National Quality Award recognize?
• Which type of insurance plan is characterized as an indemnity plan?
• Which organization's work in patient safety is summarized in the report "To Err is Human: Building a Safer Health System"?
• In malpractice cases, what does “harm was caused by the doctor” refer to?
• Which of the following is NOT mentioned as a use for profiling tools?
• The purpose of documentation in Risk Management is to?
• In the context of patient safety, who is Avedis Donabedian known for?
• What distinguishes credentialing from competency?