HCCA - CHPC Study Questions (MASTER | Questions with
100% Verified Answers | Latest Update 2026/2027
Question: What is the purpose of HIPAA?
Answer: • Protect PHI from unauthorized disclosure/use;
• Prevent fraud, waste and abuse (via Administrative Simplification);
• Make health insurance portable under ERISA;
• Move health care onto a nationally standardized electronic billing platform
Ref. https://quizlet.com/6202453/hcca-chpc-overview-flash-cards/
More on HIPAA: https://www.hhs.gov/hipaa/index.html
Question: HIPAA resides in which CFR section?
Answer: 45 CFR sections 164.102 through 164.534
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
Question: What are the subparts of HIPAA part 164?
Answer: HIPAA - 45 CFR 164, subparts:
Subpart A - General rules
Subpart C - Security
Subpart D - Breach notification
Subpart E - Privacy
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
Question: How do you determine if an organization is a "Covered Entity"?
Answer: 1. compare if the organization meets one of the 3 types of CE (provider, health plan,
clearinghouse)
and
2. determine if the organization electronically transmits one of the 9 defined
transactions:
• Health claims or equivalent encounter information
• Health claims attachments
• Enrollment and disenrollment in a health plan
• Eligibility for a health plan
• Health care payment and remittance advice
• Health plan premium payments
• First report of injury
• Health claim status
• Referral certification and authorization
In addition, business associates of covered entities must follow parts of the HIPAA
regulations.
https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
,Question: This Act established in 1974 was created for government agencies placing
restrictions on how the government can share the information maintained in
Federal systems of records that might infringe on an individual's privacy rights with
other individuals and agencies.
Answer: The Privacy Act of 1974
Question: Which of the following is not considered a HIPAA Entity Designation: 1. Affiliated
covered entity 2. Entity that performs healthcare and non-healthcare component
activities including both covered and non- covered functions 3. A group health plan
4. Contract arrangement with FEDEX carrier
Answer: 4. Contract arrangement with FEDEX carrier
Question: What is Gramm-Leach-Bliley Act (GLBA)?
Answer: Gramm-Leach-Bliley Act (GLBA), also known as the Financial Services Modernization
Act
of 1999, includes The Financial Privacy Rule and The Safeguards Rule requires all
financial
institutions to protect customer's personal financial information.
Question: What is an OHCA?
Answer: OHCA (Organized Health Care Arrangement) it's a clinically integrated care setting
where individuals receive health care from more than one provider.
These are joint arrangements/activities and have an Integrated Delivery System for
easy
exchange of PHI data. See 45 CFR 160.103. OHCAs can also utilize a joint NPP. See 45
CFR § 164.520(d).
ACE (Affiliated Covered Entity) do not have an Integrated Delivery System because
these are legally separate covered entities that are associated in business, or
affiliated as
a result of some common control or ownership.
Both the OHCA and the ACE would allow sharing of PHI across participating entity
lines
for treatment, payment, operations purposes (TPO).
,Question: What's an ACE?
Answer: ACE (Affiliated Covered Entity)
Legally separate covered entities that share common control/ownership and
designate
themselves as a single CE for the purpose of complying with the HIPAA Privacy
standards.
ACEs do not have an Integrated Delivery System, while OHCA do, and can share a
single
NPP. See 45 CFR § 164.520(d)
ACE example: a health system composed on several affiliated hospitals.
Both the OHCA and the ACE would allow sharing of PHI across participating entity
lines
for treatment, payment, operations purposes (TPO).
Question: What's a Hybrid Entity?
Answer: Entity that conducts both covered functions (or healthcare-functions) and
non-covered
functions (other biz/non-healthcare functions) to elect to be a "hybrid entity."
For instance, a University System that has a research laboratory or academic medical
center.
The post-secondary functions (non-healthcare components) do NOT need to comply
with HIPAA.
The research lab/med center functions (healthcare component) needs to comply with
HIPAA provisions to protect the use/disclosure of PHI involved.
https://www.hhs.gov/hipaa/for-professionals/faq/315/when-does-a-covered-entity-
have-discretion-to-determine-covered-
functions/index.html#:~:text=For%20example%2C%20a%20hybrid%20entity,hybrid%20enti
ty's%20health%20care%20component.
https://privacyruleandresearch.nih.gov/pr_06.asp
Question: The transmission of information between two parties to carry out financial or
administrative activities related to health care
Answer: Transaction (healthcare transaction).
Question: is called:
Answer: Few examples of healthcare transactions:
healthcare claims;
coordination of benefits;
health plan premium payments;
remittance advice (or ETF, electronic fund transfer);
referral certification and authorization
, Question: What are examples of a BA?
Answer: BA (Business Associate) - performs functions or activities on behalf of a covered
entity
that involve access by the business associate to protected health information.
Examples:
claims processing
data analysis
billing
benefit management
quality assurance
quality improvement
practice management
legal
actuarial
accounting
accreditation
other administrative services
https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/business-
associates/index.html
Question: True or False: A hospital is not required to have a business associate
Answer: TRUE
Question: contract with the specialist to whom it refers a patient and transmits the patient's
medical chart for treatment purposes.
Answer: Remember, use and disclosure of PHI for purposes of TPO requires no specific
authorization
Question: True or False: Business Associates After HITECH:
Answer: TRUE
100% Verified Answers | Latest Update 2026/2027
Question: What is the purpose of HIPAA?
Answer: • Protect PHI from unauthorized disclosure/use;
• Prevent fraud, waste and abuse (via Administrative Simplification);
• Make health insurance portable under ERISA;
• Move health care onto a nationally standardized electronic billing platform
Ref. https://quizlet.com/6202453/hcca-chpc-overview-flash-cards/
More on HIPAA: https://www.hhs.gov/hipaa/index.html
Question: HIPAA resides in which CFR section?
Answer: 45 CFR sections 164.102 through 164.534
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
Question: What are the subparts of HIPAA part 164?
Answer: HIPAA - 45 CFR 164, subparts:
Subpart A - General rules
Subpart C - Security
Subpart D - Breach notification
Subpart E - Privacy
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
Question: How do you determine if an organization is a "Covered Entity"?
Answer: 1. compare if the organization meets one of the 3 types of CE (provider, health plan,
clearinghouse)
and
2. determine if the organization electronically transmits one of the 9 defined
transactions:
• Health claims or equivalent encounter information
• Health claims attachments
• Enrollment and disenrollment in a health plan
• Eligibility for a health plan
• Health care payment and remittance advice
• Health plan premium payments
• First report of injury
• Health claim status
• Referral certification and authorization
In addition, business associates of covered entities must follow parts of the HIPAA
regulations.
https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
,Question: This Act established in 1974 was created for government agencies placing
restrictions on how the government can share the information maintained in
Federal systems of records that might infringe on an individual's privacy rights with
other individuals and agencies.
Answer: The Privacy Act of 1974
Question: Which of the following is not considered a HIPAA Entity Designation: 1. Affiliated
covered entity 2. Entity that performs healthcare and non-healthcare component
activities including both covered and non- covered functions 3. A group health plan
4. Contract arrangement with FEDEX carrier
Answer: 4. Contract arrangement with FEDEX carrier
Question: What is Gramm-Leach-Bliley Act (GLBA)?
Answer: Gramm-Leach-Bliley Act (GLBA), also known as the Financial Services Modernization
Act
of 1999, includes The Financial Privacy Rule and The Safeguards Rule requires all
financial
institutions to protect customer's personal financial information.
Question: What is an OHCA?
Answer: OHCA (Organized Health Care Arrangement) it's a clinically integrated care setting
where individuals receive health care from more than one provider.
These are joint arrangements/activities and have an Integrated Delivery System for
easy
exchange of PHI data. See 45 CFR 160.103. OHCAs can also utilize a joint NPP. See 45
CFR § 164.520(d).
ACE (Affiliated Covered Entity) do not have an Integrated Delivery System because
these are legally separate covered entities that are associated in business, or
affiliated as
a result of some common control or ownership.
Both the OHCA and the ACE would allow sharing of PHI across participating entity
lines
for treatment, payment, operations purposes (TPO).
,Question: What's an ACE?
Answer: ACE (Affiliated Covered Entity)
Legally separate covered entities that share common control/ownership and
designate
themselves as a single CE for the purpose of complying with the HIPAA Privacy
standards.
ACEs do not have an Integrated Delivery System, while OHCA do, and can share a
single
NPP. See 45 CFR § 164.520(d)
ACE example: a health system composed on several affiliated hospitals.
Both the OHCA and the ACE would allow sharing of PHI across participating entity
lines
for treatment, payment, operations purposes (TPO).
Question: What's a Hybrid Entity?
Answer: Entity that conducts both covered functions (or healthcare-functions) and
non-covered
functions (other biz/non-healthcare functions) to elect to be a "hybrid entity."
For instance, a University System that has a research laboratory or academic medical
center.
The post-secondary functions (non-healthcare components) do NOT need to comply
with HIPAA.
The research lab/med center functions (healthcare component) needs to comply with
HIPAA provisions to protect the use/disclosure of PHI involved.
https://www.hhs.gov/hipaa/for-professionals/faq/315/when-does-a-covered-entity-
have-discretion-to-determine-covered-
functions/index.html#:~:text=For%20example%2C%20a%20hybrid%20entity,hybrid%20enti
ty's%20health%20care%20component.
https://privacyruleandresearch.nih.gov/pr_06.asp
Question: The transmission of information between two parties to carry out financial or
administrative activities related to health care
Answer: Transaction (healthcare transaction).
Question: is called:
Answer: Few examples of healthcare transactions:
healthcare claims;
coordination of benefits;
health plan premium payments;
remittance advice (or ETF, electronic fund transfer);
referral certification and authorization
, Question: What are examples of a BA?
Answer: BA (Business Associate) - performs functions or activities on behalf of a covered
entity
that involve access by the business associate to protected health information.
Examples:
claims processing
data analysis
billing
benefit management
quality assurance
quality improvement
practice management
legal
actuarial
accounting
accreditation
other administrative services
https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/business-
associates/index.html
Question: True or False: A hospital is not required to have a business associate
Answer: TRUE
Question: contract with the specialist to whom it refers a patient and transmits the patient's
medical chart for treatment purposes.
Answer: Remember, use and disclosure of PHI for purposes of TPO requires no specific
authorization
Question: True or False: Business Associates After HITECH:
Answer: TRUE
