HCCA - CHPC Study Guide Exam
HCCA - CHPC STUDY GUIDE EXAM 2026 –
LATEST QUESTIONS AND ANSWERS.
What is the purpose of HIPAA? -
Correct Answers -• 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? -
Correct Answers -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? -
Correct Answers -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
, HCCA - CHPC Study Guide Exam
Correct Answers -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
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. -
Correct Answers -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
4. Contract arrangement with FEDEX carrier -
2
, HCCA - CHPC Study Guide Exam
Correct Answers -4. Contract arrangement with FEDEX carrier
What is Gramm-Leach-Bliley Act (GLBA)? -
Correct Answers -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? -
Correct Answers -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).
What's an ACE? -
Correct Answers -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)
3
, HCCA - CHPC Study Guide Exam
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).
What's a Hybrid Entity? -
Correct Answers -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%20hyb
rid%20entity,hybrid%20entity's%20health%20care%20compon
ent.
https://privacyruleandresearch.nih.gov/pr_06.asp
The transmission of information between two parties to carry
out financial or administrative activities related to health care is
called: -
Correct Answers -Transaction (healthcare transaction).
Few examples of healthcare transactions:
healthcare claims;
4
HCCA - CHPC STUDY GUIDE EXAM 2026 –
LATEST QUESTIONS AND ANSWERS.
What is the purpose of HIPAA? -
Correct Answers -• 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? -
Correct Answers -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? -
Correct Answers -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
, HCCA - CHPC Study Guide Exam
Correct Answers -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
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. -
Correct Answers -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
4. Contract arrangement with FEDEX carrier -
2
, HCCA - CHPC Study Guide Exam
Correct Answers -4. Contract arrangement with FEDEX carrier
What is Gramm-Leach-Bliley Act (GLBA)? -
Correct Answers -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? -
Correct Answers -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).
What's an ACE? -
Correct Answers -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)
3
, HCCA - CHPC Study Guide Exam
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).
What's a Hybrid Entity? -
Correct Answers -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%20hyb
rid%20entity,hybrid%20entity's%20health%20care%20compon
ent.
https://privacyruleandresearch.nih.gov/pr_06.asp
The transmission of information between two parties to carry
out financial or administrative activities related to health care is
called: -
Correct Answers -Transaction (healthcare transaction).
Few examples of healthcare transactions:
healthcare claims;
4
