HCCA CHC/CHPC COMPLIANCE EXAM
2026/2027 QUESTIONS AND ANSWERS
LATEST UPDATE THIS YEAR - JUST
RELEASED
1. Under the Federal Sentencing Guidelines for Organizations (FSGO), what is the primary
factor that can significantly reduce the culpability score of a healthcare organization facing
criminal charges?
A. The existence of an effective compliance and ethics program at the time of the offense.
B. The organization’s history of low-profit margins.
C. The immediate dismissal of all employees involved in the misconduct.
D. The use of outside legal counsel to conduct all internal audits.
Answer: A
Conceptual Explanation: The FSGO provides that the culpability score can be reduced if
the organization had an effective compliance and ethics program in place prior to the
misconduct and reported the offense promptly.
2. When conducting a Stark Law analysis, which of the following is considered a ‘designated
health service’ (DHS)?
A. Internal medicine consultations.
,B. Outpatient prescription drugs.
C. Physical therapy services.
D. Preventive screenings not covered by Medicare.
Answer: C
Conceptual Explanation: Stark Law defines DHS to include physical therapy, clinical
laboratory services, imaging, and several other specific categories of healthcare services.
3. A Compliance Officer discovers that a physician is receiving free office space from a
hospital in exchange for referrals. Which statute is primarily violated?
A. Health Information Technology for Economic and Clinical Health (HITECH) Act
B. Emergency Medical Treatment and Labor Act (EMTALA)
C. Anti-Kickback Statute (AKS)
D. Genetic Information Nondiscrimination Act (GINA)
Answer: C
Conceptual Explanation: The Anti-Kickback Statute prohibits the exchange of anything of
value (remuneration) to induce or reward referrals for items or services payable by federal
healthcare programs.
4. Under HIPAA, how many days does a ‘covered entity’ have to notify individuals of a breach
of unsecured protected health information (PHI) after the discovery of the breach?
A. No later than 30 calendar days.
, B. Within 10 business days.
C. No later than 60 calendar days.
D. Immediately upon discovery.
Answer: C
Conceptual Explanation: The HIPAA Breach Notification Rule requires notifications to be
sent without unreasonable delay and in no case later than 60 calendar days after the
discovery of a breach.
5. What is the ‘Knowledge Standard’ required to establish a violation of the False Claims Act
(FCA)?
A. Specific intent to defraud the government.
B. Proof that the person was aware of the specific law being violated.
C. Negligent failure to verify the accuracy of a claim.
D. Actual knowledge, deliberate ignorance, or reckless disregard for the truth.
Answer: D
Conceptual Explanation: The FCA defines ‘knowing’ as having actual knowledge of the
information, acting in deliberate ignorance of the truth or falsity, or acting in reckless
disregard of the truth or falsity. No proof of specific intent to defraud is required.
2026/2027 QUESTIONS AND ANSWERS
LATEST UPDATE THIS YEAR - JUST
RELEASED
1. Under the Federal Sentencing Guidelines for Organizations (FSGO), what is the primary
factor that can significantly reduce the culpability score of a healthcare organization facing
criminal charges?
A. The existence of an effective compliance and ethics program at the time of the offense.
B. The organization’s history of low-profit margins.
C. The immediate dismissal of all employees involved in the misconduct.
D. The use of outside legal counsel to conduct all internal audits.
Answer: A
Conceptual Explanation: The FSGO provides that the culpability score can be reduced if
the organization had an effective compliance and ethics program in place prior to the
misconduct and reported the offense promptly.
2. When conducting a Stark Law analysis, which of the following is considered a ‘designated
health service’ (DHS)?
A. Internal medicine consultations.
,B. Outpatient prescription drugs.
C. Physical therapy services.
D. Preventive screenings not covered by Medicare.
Answer: C
Conceptual Explanation: Stark Law defines DHS to include physical therapy, clinical
laboratory services, imaging, and several other specific categories of healthcare services.
3. A Compliance Officer discovers that a physician is receiving free office space from a
hospital in exchange for referrals. Which statute is primarily violated?
A. Health Information Technology for Economic and Clinical Health (HITECH) Act
B. Emergency Medical Treatment and Labor Act (EMTALA)
C. Anti-Kickback Statute (AKS)
D. Genetic Information Nondiscrimination Act (GINA)
Answer: C
Conceptual Explanation: The Anti-Kickback Statute prohibits the exchange of anything of
value (remuneration) to induce or reward referrals for items or services payable by federal
healthcare programs.
4. Under HIPAA, how many days does a ‘covered entity’ have to notify individuals of a breach
of unsecured protected health information (PHI) after the discovery of the breach?
A. No later than 30 calendar days.
, B. Within 10 business days.
C. No later than 60 calendar days.
D. Immediately upon discovery.
Answer: C
Conceptual Explanation: The HIPAA Breach Notification Rule requires notifications to be
sent without unreasonable delay and in no case later than 60 calendar days after the
discovery of a breach.
5. What is the ‘Knowledge Standard’ required to establish a violation of the False Claims Act
(FCA)?
A. Specific intent to defraud the government.
B. Proof that the person was aware of the specific law being violated.
C. Negligent failure to verify the accuracy of a claim.
D. Actual knowledge, deliberate ignorance, or reckless disregard for the truth.
Answer: D
Conceptual Explanation: The FCA defines ‘knowing’ as having actual knowledge of the
information, acting in deliberate ignorance of the truth or falsity, or acting in reckless
disregard of the truth or falsity. No proof of specific intent to defraud is required.
