HCCA CHC/CHPC COMPREHENSIVE
PROFESSIONAL EXAM QUESTIONS
AND ANSWERS LATEST UPDATE THIS
YEAR - JUST RELEASED
1. According to the OIG’s Seven Elements of an Effective Compliance Program, which
reporting structure is most strongly recommended for the Chief Compliance Officer (CCO)?
A. Reporting directly to the Chief Financial Officer (CFO)
B. Reporting directly to General Counsel
C. Reporting directly to the CEO and the Board of Directors
D. Reporting to the Director of Human Resources
Answer: C
Conceptual Explanation: To ensure independence and prevent conflicts of interest, the
OIG recommends that the CCO report directly to the CEO and have a direct line to the Board
of Directors, rather than being subordinate to Legal or Finance.
2. Under the Stark Law, which of the following is a primary characteristic that distinguishes it
from the Anti-Kickback Statute?
A. It is a strict liability statute
B. It requires proof of intent to violate the law
,C. It applies to all federal healthcare programs including Medicaid
D. It carries criminal penalties including imprisonment
Answer: A
Conceptual Explanation: Stark Law is a strict liability statute, meaning no proof of intent
is required to establish a violation. In contrast, the Anti-Kickback Statute requires proof of
‘knowing and willful’ intent.
3. A compliance officer discovers a potential overpayment. According to the Affordable Care
Act (ACA), what is the timeframe for reporting and returning the overpayment after it has
been identified?
A. 30 days
B. 45 days
C. 60 days
D. 90 days
Answer: C
Conceptual Explanation: The ACA requires that any overpayment 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.
, 4. Which of the following elements is NOT required to prove a violation under the Civil False
Claims Act (FCA)?
A. The claim was false or fraudulent
B. The defendant acted with ‘deliberate ignorance’ or ‘reckless disregard’
C. The defendant acted with specific intent to defraud the government
D. The claim was presented to the government for payment
Answer: C
Conceptual Explanation: The FCA defines ‘knowing’ to include actual knowledge,
deliberate ignorance, or reckless disregard. It specifically states that ‘no proof of specific
intent to defraud is required.’
5. Under HIPAA, which of the following scenarios is an example of an exception to the
‘Minimum Necessary’ standard?
A. Disclosures to a health plan for payment purposes
B. Disclosures to a healthcare provider for treatment purposes
C. Internal use by a biller to process a claim
D. Disclosures to a business associate for auditing
Answer: B
PROFESSIONAL EXAM QUESTIONS
AND ANSWERS LATEST UPDATE THIS
YEAR - JUST RELEASED
1. According to the OIG’s Seven Elements of an Effective Compliance Program, which
reporting structure is most strongly recommended for the Chief Compliance Officer (CCO)?
A. Reporting directly to the Chief Financial Officer (CFO)
B. Reporting directly to General Counsel
C. Reporting directly to the CEO and the Board of Directors
D. Reporting to the Director of Human Resources
Answer: C
Conceptual Explanation: To ensure independence and prevent conflicts of interest, the
OIG recommends that the CCO report directly to the CEO and have a direct line to the Board
of Directors, rather than being subordinate to Legal or Finance.
2. Under the Stark Law, which of the following is a primary characteristic that distinguishes it
from the Anti-Kickback Statute?
A. It is a strict liability statute
B. It requires proof of intent to violate the law
,C. It applies to all federal healthcare programs including Medicaid
D. It carries criminal penalties including imprisonment
Answer: A
Conceptual Explanation: Stark Law is a strict liability statute, meaning no proof of intent
is required to establish a violation. In contrast, the Anti-Kickback Statute requires proof of
‘knowing and willful’ intent.
3. A compliance officer discovers a potential overpayment. According to the Affordable Care
Act (ACA), what is the timeframe for reporting and returning the overpayment after it has
been identified?
A. 30 days
B. 45 days
C. 60 days
D. 90 days
Answer: C
Conceptual Explanation: The ACA requires that any overpayment 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.
, 4. Which of the following elements is NOT required to prove a violation under the Civil False
Claims Act (FCA)?
A. The claim was false or fraudulent
B. The defendant acted with ‘deliberate ignorance’ or ‘reckless disregard’
C. The defendant acted with specific intent to defraud the government
D. The claim was presented to the government for payment
Answer: C
Conceptual Explanation: The FCA defines ‘knowing’ to include actual knowledge,
deliberate ignorance, or reckless disregard. It specifically states that ‘no proof of specific
intent to defraud is required.’
5. Under HIPAA, which of the following scenarios is an example of an exception to the
‘Minimum Necessary’ standard?
A. Disclosures to a health plan for payment purposes
B. Disclosures to a healthcare provider for treatment purposes
C. Internal use by a biller to process a claim
D. Disclosures to a business associate for auditing
Answer: B
