PAPER 2026 FULL QUESTIONS AND
ACCURATE SOLUTIONS STUDY
GUIDE
◉ Appointment Timeframe - NCQA. Answer: Recredential at least every
3 years.
Cycle to the month.
◉ Appointment Timeframe - HFAP. Answer: At least every 24 months
◉ Appointment Timeframe - DNV. Answer: Not to exceed 3 years
◉ Appointment Timeframe - URAC. Answer: At least every 3 years
Cycle to the month
◉ Appointment Timeframe - AAAHC. Answer: Not to exceed 3 years
◉ Appointment Timeframe - CMS. Answer: Practitioner - at least every
24 months
Surgery - every two years
◉ Attestation Statement Timeframe - NCQA. Answer: 365 days from
final approval
,305 - CVO
◉ Attestation Statement Timeframe - URAC. Answer: 180 days prior to
credentials committee review
◉ Doesn't require attestation statement. Answer: TJC, DNV, CoPs
◉ Board Certification Time Limit - NCQA. Answer: 180 days
120 days CVO
◉ Board Certification Time Limit - URAC. Answer: 6 months
◉ Board Certification Verification Required at Recredentialing by.
Answer: NCQA - verification
HFAP - review
AAAHC
◉ What is typically monitored for expiration?. Answer: Board
certification
License (loss of license, sanctions) - NCQA
DEA - AAAHC
,◉ Board Certification Verification Required at Initial and Expiration by.
Answer: URAC
◉ PSV for Board Certification. Answer: ABMS, AMA, AOA
State licensing agency if confirmation that agency conducts PSV of
board status
Confirmation from board
◉ NCQA Approved Source: requirement for verifying source completes
PSV. Answer: Organization verifies source performs PSV
At least annually organization obtains written confirmation that source
performs PSV
◉ QAPI. Answer: Medicare CoPs require periodical appraisals of
members through Quality Assessment Performance Improvement
(QAPI) process
must include complaints regarding medical staff-related issues
◉ Complaints evaluation - NCQA. Answer: Evaluate history of
complaints for all practitioners at least every 6 months
◉ CME not addressed by. Answer: NCQA, URAC, AAAHC, CoPs
◉ Evaluation of CVO - TJC. Answer: 9 principles
, Data & Info available
processes utilized
limitations of info
identification of primary source vs. secondary source
quality control measures related to data integrity, security,
transmission, etc.
◉ Criminal Background Check - HFAP. Answer: Application requests
criminal history information for 7 - 10 years
Facility conducts background investigation as required
◉ Criminal Background Check required by. Answer: TJC, HFAP
◉ FSMB. Answer: Federation of State Medical Boards
all actions against a physician's medical licesnse
used by TJC, HFAP
Disciplinary actions: state licensing agency, board actions, or if
physician is clean.
Disciplinary alert service: notification for report of MD, DO, or PA
◉ NPDB information available:. Answer: Medical malpractice payments
Adverse licensure action