HCCA - CHC Study Questions (MASTER FLASHCARDS)
HCCA - CHC STUDY QUESTIONS
(MASTER FLASHCARDS) 2026 – LATEST
QUESTIONS AND ANSWERS.
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). -
Correct Answers -True
ref. ACA section 6102
According to HHS-OIG - what are three important reasons for
proper documentation in Compliance? (hint: protections) -
Correct Answers -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%20i
n%20patients,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
d. fourth level of appeal -
Correct Answers -c. . third level of appeal
Frist level - redetermination by Medicare contractor
Second level - reconsideration by Independent contractor
Third appeal - Administrative Law Judge (ALJ) hearing
1
, HCCA - CHC Study Questions (MASTER FLASHCARDS)
Fourth appeal - review by Medicare Appeals Council
Fifth appeal - review in Federal District Court
https://www.hhs.gov/about/agencies/omha/the-appeals-
process/index.html
What should CCO be able to do? (What skills should this person
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. -
Correct Answers -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
c. non-retaliation for whistleblowers
d. reliable and equal discipline -
Correct Answers -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 -
Correct Answers -d. will not be successful without the proper
oversight
Regardless of having the best written policies in place that are
reviewed/maintained consistently, and read and disseminated
2
, HCCA - CHC Study Questions (MASTER FLASHCARDS)
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 -
Correct Answers -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
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
d. Social Security Act section 1128d -
Correct Answers -c. Balance Budget Act of 1997
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.
3
, HCCA - CHC Study Questions (MASTER FLASHCARDS)
a. ACA section 6102
b. ACA section 1557
c. ACA section 6002 -
Correct Answers -b. ACA section 1557 is the correct answer.
a. ACA section 6102 requires owners, operators, and
administrators of LTC facilities to adopt effective compliance.
c. ACA section 6002 requires the establishment of a
transparency program, now known as CMS Open Payments.
Which statement is TRUE regarding compliance programs?
a. Compliance programs are considered more dangerous if they
are developed but not implemented.
b. Compliance programs can detect but not prevent criminal
conduct
c. Compliance programs are only required by law for healthcare
entities that have more than $500,000 in annual revenue.
d. Compliance programs are not mandated by law. -
Correct Answers -a. Compliance programs are considered more
dangerous if they are developed but not implemented.
An individual's understanding of the compliance aspects of
their job can BEST be enhanced by including compliance in:
a. annual evaluations
b. exit interviews
c. HR benefit materials
d. audit committee meetings -
Correct Answers -a. annual evaluations
Formal statement outlining a plan for a specified subject area.
It usually cites state and/or federal required actions or
standards.
a. CAP
b. Procedure document
4
HCCA - CHC STUDY QUESTIONS
(MASTER FLASHCARDS) 2026 – LATEST
QUESTIONS AND ANSWERS.
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). -
Correct Answers -True
ref. ACA section 6102
According to HHS-OIG - what are three important reasons for
proper documentation in Compliance? (hint: protections) -
Correct Answers -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%20i
n%20patients,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
d. fourth level of appeal -
Correct Answers -c. . third level of appeal
Frist level - redetermination by Medicare contractor
Second level - reconsideration by Independent contractor
Third appeal - Administrative Law Judge (ALJ) hearing
1
, HCCA - CHC Study Questions (MASTER FLASHCARDS)
Fourth appeal - review by Medicare Appeals Council
Fifth appeal - review in Federal District Court
https://www.hhs.gov/about/agencies/omha/the-appeals-
process/index.html
What should CCO be able to do? (What skills should this person
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. -
Correct Answers -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
c. non-retaliation for whistleblowers
d. reliable and equal discipline -
Correct Answers -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 -
Correct Answers -d. will not be successful without the proper
oversight
Regardless of having the best written policies in place that are
reviewed/maintained consistently, and read and disseminated
2
, HCCA - CHC Study Questions (MASTER FLASHCARDS)
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 -
Correct Answers -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
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
d. Social Security Act section 1128d -
Correct Answers -c. Balance Budget Act of 1997
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.
3
, HCCA - CHC Study Questions (MASTER FLASHCARDS)
a. ACA section 6102
b. ACA section 1557
c. ACA section 6002 -
Correct Answers -b. ACA section 1557 is the correct answer.
a. ACA section 6102 requires owners, operators, and
administrators of LTC facilities to adopt effective compliance.
c. ACA section 6002 requires the establishment of a
transparency program, now known as CMS Open Payments.
Which statement is TRUE regarding compliance programs?
a. Compliance programs are considered more dangerous if they
are developed but not implemented.
b. Compliance programs can detect but not prevent criminal
conduct
c. Compliance programs are only required by law for healthcare
entities that have more than $500,000 in annual revenue.
d. Compliance programs are not mandated by law. -
Correct Answers -a. Compliance programs are considered more
dangerous if they are developed but not implemented.
An individual's understanding of the compliance aspects of
their job can BEST be enhanced by including compliance in:
a. annual evaluations
b. exit interviews
c. HR benefit materials
d. audit committee meetings -
Correct Answers -a. annual evaluations
Formal statement outlining a plan for a specified subject area.
It usually cites state and/or federal required actions or
standards.
a. CAP
b. Procedure document
4
