Continuing Medical Education
Morton Plant Hospital (MS 611)
807 N. Myrtle Avenue
Clearwater, FL  33755
727-467-2517 Phone
727-467-2459 Fax

CONTINUING MEDICAL EDUCATION ACTIVITY EVALUATION AND TEST FORM
Complete and return to receive CME credit


Corporate Integrity
 
Not Valid For CME Credit After December 31, 2019

 

Jeffrey Durham, VP Audit Services & Corporate Responsibility – BayCare Health Systems

 
  Objectives: Discuss Stark and Compliance Regulations.





All fields in red are mandatory

Name:

Email:

If you are new to our CME Program, or if your status has changed, please complete this section of the form.

Phone:

Street Address:
City: , State: Zip:



Please mark the appropiate bubble next to each catagory that expresses your evaluation of this CME activity
Strongly Agree Agree Neutral Disagree Strongly Disagree
1. Speaker(s) knowledge of topic
2. Met program learning Objectives: as listed above

3. Overall presentation was balanced, objective, & scientifically rigorous
4. The activity was scientifically sound & free of commercial bias/influence
5. The content of this activity matched  my current (or potential) scope of  practice
6. Was there an opportunity to discuss practice-relevant issues with the speaker(s)?
7. Please identify how you may improve your competence and/or performance as a result of attending this activity
      (select all that apply):  
This activity validated my current practice; no changes will be made
Create/revise protocols, policies, and/or procedures
Change the management and/or treatment of my patients
Other, please specify:

8. Are there any barriers you perceive in implementing these changes:
  No barriers
Yes, please explain:
9.How might this activity be improved?   
    
10. Please describe any clinical situations that you find difficult to manage or resolve that you would like to see addressed in
      future educational activities:
     




Test

Please note that at least 4 questions must be answered correctly to get credit

  

Question 1       What is the length of time Morton Plant Mease's Corporate Integrity Agreement lasts?
      A      1 year
      B      3 years
      C      5 years
      D      7 years
   
Question 2       Who is the Compliance Officer (CRO) for Morton Plant Mease?
      A      Glenn Waters
      B      Jeff Durham
      C      Kris Hoce
      D      Carl Tremonti
   
Question 3       Which federal agency investigates potential HIPAA violations?
      A      Office of Inspector General (OIG)
      B      Department of Justice (DOJ)
      C      Internal Revenue Service (IRS)
      D      Office for Civil Rights (OCR)
   
Question 4       Which is not a required element of a valid order?
      A      Signed
      B      Dated
      C      Initialed
      D      Timed
   
Question 5       What is the primary enforcement tool used to prosecute fraudulent billings to the government?
      A      Anti-Kickback Statute
      B      Civil Monetary Penalties
      C      False Claims Act
      D      Stark Law
   
Question 6       What length of time do providers have to return identified overpayments to the government?
      A      30 days
      B      60 days
      C      6 months
      D      1 year

Please note that at least 4 questions must be answered correctly to get credit