The Justice Health Plan Is Eligible to Submit Reportable Actions

question 77

Multiple Choice

The Justice Health Plan is eligible to submit reportable actions against medical practitioners to the National Practitioner Data Bank (NPDB) . Justice is considering whether it should report the following actions to the NPDB: Action 1--A medical malpractice insurer made a malpractice payment on behalf of a dentist in Justice's network for a complaint that was settled out of court. Action 2--Justice reprimanded a PCP in its network for failing to follow the health plan's referral procedures. Action 3--Justice suspended a physician's clinical privileges throughout the Justice network because the physician's conduct adversely affected the welfare of a patient. Action 4--Justice censured a physician for advertising practices that were not aligned with Justice's marketing philosophy. Of these actions, the ones that Justice most likely must report to the NPDB include Actions

• A) 1, 2, and 3 only
• B) 1 and 3 only
• C) 2 and 4 only
• D) 3 and 4 only

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Definitions:

IFRS

International Financial Reporting Standards, a set of accounting standards that provide guidelines for financial reporting, aiming to make company accounts understandable and comparable across international boundaries.

GAAP

In any particular legal area, the Generally Accepted Accounting Principles are the recognized standard of guidelines for conducting financial accounting.

Probable

Probable refers to the likelihood that a future event will occur, often used in accounting to determine if a contingent event should be recorded.

Warranty Obligations

Warranty obligations are promises made by a seller to a buyer to repair, replace, or rectify defects in goods sold within a certain period after the sale.