NEW HCCA COMPLIANCE VOCAB EXAM 2025| ACTUAL EXAM QUESTIONS AND ANSWERS
LATEST UPDATED 2026/2026 (GRADED A+)
2 Midnight Rule --PRECISE ANS--Regulation included in the 2014 Medicare inpatient prospective payment rule.
Established that inpatient admissions spanning at least two midnights qualify for Medicare Part A payments. Inpatient
stays lasting fewer than two midnights must be treated and billed as outpatient services.
340B Pricing Program --PRECISE ANS--A federal program requiring drug manufacturers to provide outpatient drugs
to eligible health care organizations/covered entities at significantly reduced prices.
Academic Research Organization (ARO) --PRECISE ANS--An academic institution that performs or manages clinical
research services usually by partnering with a research sponsor.
Adjusted Average per Capita Cost (AAPCC) --PRECISE ANS--CMS/HCFA's best estimate for the amount of money
it costs to care for Medicare recipients under fee-for-services Medicare in a given area. The AAPCC is made up of
142 different rate cells; 140 of them are factored for age, sex, Medicaid eligibility, Institutional status, working ages,
and whether a person has both Part A and Part B of Medicare. The 2 remaining cells are for individuals with end
stage renal disease.
Adjusted Community Rate (ACR) --PRECISE ANS--Under the ACA, insurers can't raise premiums based on health
status, medical claims, gender, or most of the other factors that they had previously used to determine rates prior to
ACA implementation.
Advance Beneficiary Notice (ABN) --PRECISE ANS--A waiver signed by a patient confirming the patient's
understanding that certain provided services may not be reimbursable under Medicare and therefore are the patient's
responsibility.
Advanced Medical Technology Association (Advamed) --PRECISE ANS--Medical device trade association.
Adverse Drug Experience (ADE) --PRECISE ANS--Any adverse event associated with the use of a drug in humans,
whether or not considered drug-related, including the following: An adverse event occurring in the course of the use
of a drug product in professional practice; an adverse event occurring from drug
,overdose whether accidental or intentional; an adverse event occurring from drug abuse; an adverse event
occurring from drug withdrawal; and any failure of expected pharmacological action.
Adverse Drug Reaction (ADR) --PRECISE ANS--Injury caused by taking a medication.
Adverse Event (Research) (AE) --PRECISE ANS--Used broadly to mean any untoward or unfavorable medical
occurrence in a human subject, including any abnormal sign, symptom, or disease, temporally associated with the
subject's participation in research, whether or not considered related to the subject's participation in the research.
Adverse events encompass both physical and psychological harms.
Affiliated Covered Entity (ACE) --PRECISE ANS--Under HIPAA, legally separate covered entities under common
ownership or control have an option to be treated as a single legal entity by choosing to designate as ACE. This
enables the entities to share information in a way that would otherwise be impermissible (use vs. disclosure).
Agency for Healthcare Research and Quality (AHRQ) --PRECISE ANS--Agency within the Department of Health and
Human Services, whose mission is to produce evidence to make health care safer, higher quality, more accessible,
equitable, and affordable, and to work within HHS and other partners to make sure that the evidence is understood
and used.
Ambulatory Care Center (ACC) --PRECISE ANS--Medical provide with services aimed at one-day surgical patients
and non-surgical outpatients. Patients treated in ACCs include pediatric, adolescent, adult and geriatric.
Ambulatory Patient Class (APC) --PRECISE ANS--Method used to pay hospitals and surgery centers for outpatient
services using a Prospective Payment System (PPS). Each service is assigned to various APC categories.
Ambulatory Patient Groups (APG) --PRECISE ANS--A Medicare patient classification system designed to explain the
amount and types of resources consumed in an ambulatory visit. There are 290 APGs in the current version (Version
2.0) and they encompass the full range of services delivered in the ambulatory setting, including same day surgery
units, hospital emergency rooms and outpatient clinics.
Ambulatory Surgery Center (ASC) --PRECISE ANS--Medical facility providing same-day surgical care.
, American College of Healthcare Executives (ACHE) --PRECISE ANS--Professional society of healthcare executives
who lead hospitals, health systems, and other healthcare organizations.
American College of Professional Coders (AAPC) --PRECISE ANS--Professional association that provides education
and certification to medical coders.
American Health Information Management Association (AHIMA) --PRECISE ANS--Professional association for health
information management (HIM) professionals.
American Hospital Association (AHA) --PRECISE ANS--National organization that represents, educates, and
advocates for its member hospitals and health care networks.
American Recovery and Reinvestment Act of 2009 (ARRA) --PRECISE ANS--Commonly referred to as the Stimulus
Package, ARRA aims to create and maintain jobs, spur economic activity and long-term growth, and foster
accountability and transparency in government spending through tax incentives, entitlement programs, and funding
federal contracts, grants, and loans.
Ancillary Services --PRECISE ANS--Health services provided to support the primary care of a patient. Examples
include laboratory services, radiology services, and speech therapy.
Annual Contractor Evaluation Report (ACER) --PRECISE ANS--CMS's Health Care Finance Administration's formal
evaluation report of Medicare contractor's performance for the fiscal year. It is based upon results of the Contractor
Performance Evaluation Program (CPEP) reviews, along with results of other special evaluations which are
considered when evaluating contractor performance.
Anti-Kickback Statute (AKS) --PRECISE ANS--Federal criminal statute that prohibits the exchange (or offer to
exchange) of anything of value, in an effort to induce (or reward) the referral of federal health care program business.
Assignment of Benefits (AOB) --PRECISE ANS--Allows a provider to bill and receive payment directly from insurance
issuer.
LATEST UPDATED 2026/2026 (GRADED A+)
2 Midnight Rule --PRECISE ANS--Regulation included in the 2014 Medicare inpatient prospective payment rule.
Established that inpatient admissions spanning at least two midnights qualify for Medicare Part A payments. Inpatient
stays lasting fewer than two midnights must be treated and billed as outpatient services.
340B Pricing Program --PRECISE ANS--A federal program requiring drug manufacturers to provide outpatient drugs
to eligible health care organizations/covered entities at significantly reduced prices.
Academic Research Organization (ARO) --PRECISE ANS--An academic institution that performs or manages clinical
research services usually by partnering with a research sponsor.
Adjusted Average per Capita Cost (AAPCC) --PRECISE ANS--CMS/HCFA's best estimate for the amount of money
it costs to care for Medicare recipients under fee-for-services Medicare in a given area. The AAPCC is made up of
142 different rate cells; 140 of them are factored for age, sex, Medicaid eligibility, Institutional status, working ages,
and whether a person has both Part A and Part B of Medicare. The 2 remaining cells are for individuals with end
stage renal disease.
Adjusted Community Rate (ACR) --PRECISE ANS--Under the ACA, insurers can't raise premiums based on health
status, medical claims, gender, or most of the other factors that they had previously used to determine rates prior to
ACA implementation.
Advance Beneficiary Notice (ABN) --PRECISE ANS--A waiver signed by a patient confirming the patient's
understanding that certain provided services may not be reimbursable under Medicare and therefore are the patient's
responsibility.
Advanced Medical Technology Association (Advamed) --PRECISE ANS--Medical device trade association.
Adverse Drug Experience (ADE) --PRECISE ANS--Any adverse event associated with the use of a drug in humans,
whether or not considered drug-related, including the following: An adverse event occurring in the course of the use
of a drug product in professional practice; an adverse event occurring from drug
,overdose whether accidental or intentional; an adverse event occurring from drug abuse; an adverse event
occurring from drug withdrawal; and any failure of expected pharmacological action.
Adverse Drug Reaction (ADR) --PRECISE ANS--Injury caused by taking a medication.
Adverse Event (Research) (AE) --PRECISE ANS--Used broadly to mean any untoward or unfavorable medical
occurrence in a human subject, including any abnormal sign, symptom, or disease, temporally associated with the
subject's participation in research, whether or not considered related to the subject's participation in the research.
Adverse events encompass both physical and psychological harms.
Affiliated Covered Entity (ACE) --PRECISE ANS--Under HIPAA, legally separate covered entities under common
ownership or control have an option to be treated as a single legal entity by choosing to designate as ACE. This
enables the entities to share information in a way that would otherwise be impermissible (use vs. disclosure).
Agency for Healthcare Research and Quality (AHRQ) --PRECISE ANS--Agency within the Department of Health and
Human Services, whose mission is to produce evidence to make health care safer, higher quality, more accessible,
equitable, and affordable, and to work within HHS and other partners to make sure that the evidence is understood
and used.
Ambulatory Care Center (ACC) --PRECISE ANS--Medical provide with services aimed at one-day surgical patients
and non-surgical outpatients. Patients treated in ACCs include pediatric, adolescent, adult and geriatric.
Ambulatory Patient Class (APC) --PRECISE ANS--Method used to pay hospitals and surgery centers for outpatient
services using a Prospective Payment System (PPS). Each service is assigned to various APC categories.
Ambulatory Patient Groups (APG) --PRECISE ANS--A Medicare patient classification system designed to explain the
amount and types of resources consumed in an ambulatory visit. There are 290 APGs in the current version (Version
2.0) and they encompass the full range of services delivered in the ambulatory setting, including same day surgery
units, hospital emergency rooms and outpatient clinics.
Ambulatory Surgery Center (ASC) --PRECISE ANS--Medical facility providing same-day surgical care.
, American College of Healthcare Executives (ACHE) --PRECISE ANS--Professional society of healthcare executives
who lead hospitals, health systems, and other healthcare organizations.
American College of Professional Coders (AAPC) --PRECISE ANS--Professional association that provides education
and certification to medical coders.
American Health Information Management Association (AHIMA) --PRECISE ANS--Professional association for health
information management (HIM) professionals.
American Hospital Association (AHA) --PRECISE ANS--National organization that represents, educates, and
advocates for its member hospitals and health care networks.
American Recovery and Reinvestment Act of 2009 (ARRA) --PRECISE ANS--Commonly referred to as the Stimulus
Package, ARRA aims to create and maintain jobs, spur economic activity and long-term growth, and foster
accountability and transparency in government spending through tax incentives, entitlement programs, and funding
federal contracts, grants, and loans.
Ancillary Services --PRECISE ANS--Health services provided to support the primary care of a patient. Examples
include laboratory services, radiology services, and speech therapy.
Annual Contractor Evaluation Report (ACER) --PRECISE ANS--CMS's Health Care Finance Administration's formal
evaluation report of Medicare contractor's performance for the fiscal year. It is based upon results of the Contractor
Performance Evaluation Program (CPEP) reviews, along with results of other special evaluations which are
considered when evaluating contractor performance.
Anti-Kickback Statute (AKS) --PRECISE ANS--Federal criminal statute that prohibits the exchange (or offer to
exchange) of anything of value, in an effort to induce (or reward) the referral of federal health care program business.
Assignment of Benefits (AOB) --PRECISE ANS--Allows a provider to bill and receive payment directly from insurance
issuer.
