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HCCA - CHC Study Questions (MASTER FLASHCARDS) Questions and Answers (100% Correct Answers) Already Graded A+

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HCCA - CHC Study Questions (MASTER FLASHCARDS) Questions and Answers (100% Correct Answers) Already Graded A+

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Subido en
20 de octubre de 2025
Número de páginas
244
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HCCA - CHC Study Questions (MASTER
FLASHCARDS) Questions and Answers
(100% Correct Answers) Already Graded
A+
True or False:

The ACA requires that all providers adopt a compliance plan as a
condition of enrollment with Medicare, Medicaid, and Children's
Health Insurance Program (CHIP). [ ANS: ] True
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ref. ACA section 6102
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According to HHS-OIG - what are three important reasons for
proper documentation in Compliance? (hint: protections) [ ANS: ]
1.Protect our programs

2.Protect your patients

3.Protect the Provider



https://oig.hhs.gov/newsroom/podcasts/2011/heat/heat09-
trans.asp#:~:text=Proper%20documentation%2C%20both%20in%20
patients,to%20protect%20you%20the%20provider.

At which level of the Medicare Part A or Part B appeals process is
the appeal decision by the Office of Medicare Hearings and
Appeals (OMHA)?

a. first level of appeal

b. second level of appeal

c. third level of appeal

, 2
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d. fourth level of appeal [ ANS: ] c. . third level of appeal



Frist level - redetermination by Medicare contractor

Second level - reconsideration by Independent contractor

Third appeal - Administrative Law Judge (ALJ) hearing

Fourth appeal - review by Medicare Appeals Council

Fifth appeal - review in Federal District Court
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https://www.hhs.gov/about/agencies/omha/the-appeals-
process/index.html

What should CCO be able to do? (What skills should this person
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have?) Choose all that apply.

a. Leadership skills.

b. Oversee the coding department.

c. Skills to design and implement a compliance program.

d. Be able to anticipate new risk areas.

e. Practical experience with documenting medical necessity. [
ANS: ] a. Leadership skills,

c. Skills to design and implement a compliance program, and

d. Be able to anticipate new risk areas.

Which of the following is an absolute necessity in order to have a
successful Compliance Program?

a. continuous training and improvements

b. effective reporting path

, 3
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c. non-retaliation for whistleblowers

d. reliable and equal discipline [ ANS: ] c. non-retaliation for
whistleblowers

A Compliance Program with well written policies and procedures:

a. can be successful if consistently reviewed and maintained

b. cannot be effective due to the sheer volume presented

c. will be effective if read by management

d. will not be successful without the proper oversight [ ANS: ] d. will
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not be successful without the proper oversight
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Regardless of having the best written policies in place that are
reviewed/maintained consistently, and read and disseminated
accordingly, will fail if there is no proper oversight to ensure they
are actually being followed and understood.

A Compliance Officer can achieve a higher level of compliance
and ethics engagement by:

a. ensuring leadership reads the policies

b. increasing management involvement

c. responding to compliance hotline calls

d. monitoring the code of conduct [ ANS: ] b. increasing
management involvement.



Compliance is everyone's responsibility, but management
involvement is crucial. They have a direct contact with
employees, they know and understand their staff's needs and
concerns, and have the most influence over employee's actions

, 4
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and attitudes. Employees most likely use their direct manager(s) to
raise concerns and the reason they are so critical for an
organization to foster a culture of compliance.

Which of the following requires providers to be permanently
excluded from all federal health care programs if found guilty of a
healthcare related fraud a third time:

a. Deficit Reduction Act of 2005

b. False Claims Act

c. Balance Budget Act of 1997
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d. Social Security Act section 1128d [ ANS: ] c. Balance Budget Act
of 1997
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Also known as a BBA "three strikes rule"

What section of the ACA prevents discrimination against
individuals with limited English proficiency (LEP), and also prohibits
discrimination in healthcare programs and activities that receive
federal funding, based on race, color, national origin, sex, age, or
disability.

a. ACA section 6102

b. ACA section 1557

c. ACA section 6002 [ ANS: ] b. ACA section 1557 is the correct
answer.




a. ACA section 6102 requires owners, operators, and
administrators of LTC facilities to adopt effective compliance.
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