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Is the following true or false?
According to NCQA standards, an organization must verify santions or limitation on licenseure in each state where the practioner holds or has ever held licensure.



This question is part of CPCS Practice Questions
Asked by Coulter, Last updated: Feb 06, 2021

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2 Answers

Alan Gray

Alan Gray

Alan Gray
Alan Gray

Answered Sep 06, 2018

Why would you not? I have seen a provider with significant issues in one state that prevented them from getting privileges. The issues were not reported to the current state. You are trying to obtain a picture of their history and make sure it is clean. Not just check the state they have had a license in for only a year. They could be an axe murderer hopping around state to state. If they graduated in 1997 and have been in California most of that time and all of a sudden they have moved cross country? You want to obtain prior malpractice claims histories why would you not want to check licencesuresin all states they have held?

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John Smith

John Smith

John Smith
John Smith

Answered May 23, 2017

False

Only in the state where the practitioner provides care for its members.
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