1 | P a g e | © copyright 2024/2025 | Grade A+
HCCA - CHPC Study Questions (MASTER
FLASHCARDS) Questions and Correct
Answers | Latest Update
What is the purpose of HIPAA?
✓ ~~>• 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
HIPAA resides in which CFR section?
✓ ~~>45 CFR sections 164.102 through 164.534
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
What are the subparts of HIPAA part 164?
Master01 | September, 2024/2025 | Latest update
, 2 | P a g e | © copyright 2024/2025 | Grade A+
✓ ~~>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
How do you determine if an organization is a "Covered Entity"?
✓ ~~>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
Master01 | September, 2024/2025 | Latest update
, 3 | P a g e | © copyright 2024/2025 | Grade A+
• 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
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.
✓ ~~>The Privacy Act of 1974
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
Master01 | September, 2024/2025 | Latest update
, 4 | P a g e | © copyright 2024/2025 | Grade A+
4. Contract arrangement with FEDEX carrier
✓ ~~>4. Contract arrangement with FEDEX carrier
What is Gramm-Leach-Bliley Act (GLBA)?
✓ ~~>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.
What is an OHCA?
✓ ~~>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.
Master01 | September, 2024/2025 | Latest update
HCCA - CHPC Study Questions (MASTER
FLASHCARDS) Questions and Correct
Answers | Latest Update
What is the purpose of HIPAA?
✓ ~~>• 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
HIPAA resides in which CFR section?
✓ ~~>45 CFR sections 164.102 through 164.534
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
What are the subparts of HIPAA part 164?
Master01 | September, 2024/2025 | Latest update
, 2 | P a g e | © copyright 2024/2025 | Grade A+
✓ ~~>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
How do you determine if an organization is a "Covered Entity"?
✓ ~~>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
Master01 | September, 2024/2025 | Latest update
, 3 | P a g e | © copyright 2024/2025 | Grade A+
• 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
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.
✓ ~~>The Privacy Act of 1974
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
Master01 | September, 2024/2025 | Latest update
, 4 | P a g e | © copyright 2024/2025 | Grade A+
4. Contract arrangement with FEDEX carrier
✓ ~~>4. Contract arrangement with FEDEX carrier
What is Gramm-Leach-Bliley Act (GLBA)?
✓ ~~>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.
What is an OHCA?
✓ ~~>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.
Master01 | September, 2024/2025 | Latest update
