HCCA CHC/CHPC COMPREHENSIVE
COMPLIANCE PRACTICE EXAM
QUESTIONS AND ANSWERS LATEST
UPDATE THIS YEAR - JUST RELEASED
1. According to the OIG’s Compliance Program Guidance, what is considered the ‘backbone’
of an effective compliance program?
A. Regular internal auditing and monitoring
B. The designation of a compliance officer and compliance committee
C. Written policies, procedures, and standards of conduct
D. Developing effective lines of communication
Answer: C
Conceptual Explanation: While all seven elements are essential, the OIG emphasizes that
written standards of conduct and policies provide the necessary foundation and guidance
for the entire organization’s compliance efforts.
2. Under the False Claims Act, what is the ‘scienter’ requirement for liability to attach?
A. Actual knowledge, deliberate ignorance, or reckless disregard of the truth
B. Specific intent to defraud the government must be proven
C. A simple mistake or negligence in billing
,D. Proof of a conspiracy between two or more parties
Answer: A
Conceptual Explanation: The False Claims Act does not require proof of specific intent to
defraud. Liability can be established through actual knowledge, deliberate ignorance, or
reckless disregard (often called the ‘scienter’ requirement).
3. Which of the following is a key difference between the Anti-Kickback Statute (AKS) and the
Stark Law?
A. AKS is a strict liability statute, while Stark requires intent
B. Stark applies to all federal healthcare programs, while AKS only applies to Medicare
C. AKS is intent-based and criminal, while Stark is a civil strict liability statute
D. Stark covers any referral, while AKS only covers referrals from physicians
Answer: C
Conceptual Explanation: The Anti-Kickback Statute is a criminal law that requires
‘knowing and willful’ intent. The Stark Law is a civil, strict liability statute regarding
physician self-referrals for designated health services.
4. A hospital discovers a billing error that resulted in a $50,000 overpayment from Medicare.
Under the ‘60-Day Rule,’ when does the obligation to report and return begin?
A. 60 days from the date the overpayment was received
B. 60 days from the end of the fiscal year
, C. 60 days from the date the overpayment is identified
D. Immediately upon the first suspicion of an error
Answer: C
Conceptual Explanation: The Affordable Care Act (ACA) requires that overpayments be
reported and returned by the later of 60 days after the date on which the overpayment was
identified or the date any corresponding cost report is due.
5. Under HIPAA, which of the following is NOT an ‘Administrative Safeguard’ required by the
Security Rule?
A. Workstation Security
B. Risk Analysis
C. Sanction Policy
D. Information Access Management
Answer: A
Conceptual Explanation: Workstation Security is a Physical Safeguard. Risk Analysis,
Sanction Policy, and Information Access Management are all Administrative Safeguards
under 45 CFR § 164.308.
6. When conducting a risk assessment, what is the primary purpose of ‘Likelihood’ and
‘Impact’ scores?
A. To prioritize risks for the annual work plan
COMPLIANCE PRACTICE EXAM
QUESTIONS AND ANSWERS LATEST
UPDATE THIS YEAR - JUST RELEASED
1. According to the OIG’s Compliance Program Guidance, what is considered the ‘backbone’
of an effective compliance program?
A. Regular internal auditing and monitoring
B. The designation of a compliance officer and compliance committee
C. Written policies, procedures, and standards of conduct
D. Developing effective lines of communication
Answer: C
Conceptual Explanation: While all seven elements are essential, the OIG emphasizes that
written standards of conduct and policies provide the necessary foundation and guidance
for the entire organization’s compliance efforts.
2. Under the False Claims Act, what is the ‘scienter’ requirement for liability to attach?
A. Actual knowledge, deliberate ignorance, or reckless disregard of the truth
B. Specific intent to defraud the government must be proven
C. A simple mistake or negligence in billing
,D. Proof of a conspiracy between two or more parties
Answer: A
Conceptual Explanation: The False Claims Act does not require proof of specific intent to
defraud. Liability can be established through actual knowledge, deliberate ignorance, or
reckless disregard (often called the ‘scienter’ requirement).
3. Which of the following is a key difference between the Anti-Kickback Statute (AKS) and the
Stark Law?
A. AKS is a strict liability statute, while Stark requires intent
B. Stark applies to all federal healthcare programs, while AKS only applies to Medicare
C. AKS is intent-based and criminal, while Stark is a civil strict liability statute
D. Stark covers any referral, while AKS only covers referrals from physicians
Answer: C
Conceptual Explanation: The Anti-Kickback Statute is a criminal law that requires
‘knowing and willful’ intent. The Stark Law is a civil, strict liability statute regarding
physician self-referrals for designated health services.
4. A hospital discovers a billing error that resulted in a $50,000 overpayment from Medicare.
Under the ‘60-Day Rule,’ when does the obligation to report and return begin?
A. 60 days from the date the overpayment was received
B. 60 days from the end of the fiscal year
, C. 60 days from the date the overpayment is identified
D. Immediately upon the first suspicion of an error
Answer: C
Conceptual Explanation: The Affordable Care Act (ACA) requires that overpayments be
reported and returned by the later of 60 days after the date on which the overpayment was
identified or the date any corresponding cost report is due.
5. Under HIPAA, which of the following is NOT an ‘Administrative Safeguard’ required by the
Security Rule?
A. Workstation Security
B. Risk Analysis
C. Sanction Policy
D. Information Access Management
Answer: A
Conceptual Explanation: Workstation Security is a Physical Safeguard. Risk Analysis,
Sanction Policy, and Information Access Management are all Administrative Safeguards
under 45 CFR § 164.308.
6. When conducting a risk assessment, what is the primary purpose of ‘Likelihood’ and
‘Impact’ scores?
A. To prioritize risks for the annual work plan
