HCCA - CHC EXAM STUDY PACK 2026 – yu yu yu yu yu yu yu
ACTUAL EXAM yu yu
QUESTIONS WITH 100% VERIFIED SOLUTIONS- yu yu yu yu
LATEST UPDATE 2026-2027/A+ GRADE yu yu yu
True or False: yu yu
The ACA requires that all providers adopt a compliance plan as a condition of enrollment with
yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu
Medicare, Medicaid, and Children's Health Insurance Program (CHIP).
yu yu yu yu yu yu yu yu
yu ✔✔True
ref. ACA section 6102
yu yu yu
According to HHS-OIG - what are three important reasons for proper documentation in
yu yu yu yu yu yu yu yu yu yu yu yu
Compliance? (hint: protections)
yu yu yu
yu ✔✔1.Protect our programs yu yu
2. Protect your patients
yu yu
3. Protect the Provider
yu yu
At which level of the Medicare Part A or Part B appeals process is the appeal decision by theOffice
yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu
of Medicare Hearings and Appeals (OMHA)?
yu yu yu yu yu
,a. first level of appeal
yu yu yu
b. second level of appeal yu yu yu
c. third level of appeal yu yu yu
d. fourth level of appeal yu yu yu
yu ✔✔c. . third level of appeal
yu yu yu yu yu
Frist level -yu yu
yu redetermination by Medicare contractor Second level - yu yu yu yu yu yu
reconsideration by Independent contractorThird appeal -
yu yu yu yu yu yu yu
yu Administrative Law Judge (ALJ) hearing Fourth appeal - yu yu yu yu yu yu yu
yu review by Medicare Appeals Council Fifth appeal -
yu yu yu yu yu yu yu
yu review in Federal District Court
yu yu yu yu
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.
yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu
a. Leadership skills. yu
b. Oversee the coding department. yu yu yu
c. Skills to design and implement a compliance program.
yu yu yu yu yu yu yu
d. Be able to anticipate new risk areas.
yu yu yu yu yu yu
e. Practical experience with documenting medical necessity.yu yu yu yu yu yu
✔✔a. Leadership skills, yu yu
,c. Skills to design and implement a compliance program, and
yu yu yu yu yu yu yu yu yu
d. Be able to anticipate new risk areas.
yu yu yu yu yu yu yu
Which of the following is an absolute necessity in order to have a successful Compliance
yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu
Program?
a. continuous training and improvements yu yu yu
b. effective reporting path yu yu
c. non-retaliation for whistle blowers yu yu
d. reliable and equal discipline yu yu yu yu
✔✔c. non-retaliation for whistle blowers
yu yu yu
A Compliance Program with well written policies and procedures:
yu yu yu yu yu yu yu yu
a. can be successful if consistently reviewed and maintained
yu yu yu yu yu yu yu
b. cannot be effective due to the sheer volume presented
yu yu yu yu yu yu yu yu
c. will be effective if read by management
yu yu yu yu yu yu
d. will not be successful without the proper oversight
yu yu yu yu yu yu yu yu
✔✔d. will not be successful without the
yu yu yu yu yu yu
proper oversight yu
A Compliance Officer can achieve a higher level of compliance and ethics engagement by:
yu yu yu yu yu yu yu yu yu yu yu yu yu
a. ensuring leadership reads the policies yu yu yu yu
, b. increasing management involvement yu yu
c. responding to compliance hotline calls yu yu yu yu
d. monitoring the code of conduct yu yu yu yu yu
✔✔b. increasing management involvement
yu yu yu
Which of the following requires providers to be permanently excluded from all federal healthcare
yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu
programs if found guilty of a healthcare related fraud a third time:
yu yu yu yu yu yu yu yu yu yu yu
a. Deficit Reduction Act of 2005
yu yu yu yu
b. False Claims Act
yu yu
c. Balance Budget Act of 1997 yu yu yu yu
d. Social Security Act section 1128
yu yu yu yu
yu ✔✔c. Balance Budget Act of 1997
yu yu yu yu yu
Also known as a BBA "three strikes rule"
yu yu yu yu yu yu yu
Which statement is TRUE regarding compliance programs?
yu yu yu yu yu yu
a. Compliance programs are considered more dangerous if they are developed but notim
yu yu yu yu yu yu yu yu yu yu yu yu
plemented.
b. Compliance programs can detect but not prevent criminal conduct
yu yu yu yu yu yu yu yu
c. Compliance programs are only required by law for healthcare entities that have more than
yu yu yu yu yu yu yu yu yu yu yu yu yu
$500,000 in annual revenue. yu yu yu
ACTUAL EXAM yu yu
QUESTIONS WITH 100% VERIFIED SOLUTIONS- yu yu yu yu
LATEST UPDATE 2026-2027/A+ GRADE yu yu yu
True or False: yu yu
The ACA requires that all providers adopt a compliance plan as a condition of enrollment with
yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu
Medicare, Medicaid, and Children's Health Insurance Program (CHIP).
yu yu yu yu yu yu yu yu
yu ✔✔True
ref. ACA section 6102
yu yu yu
According to HHS-OIG - what are three important reasons for proper documentation in
yu yu yu yu yu yu yu yu yu yu yu yu
Compliance? (hint: protections)
yu yu yu
yu ✔✔1.Protect our programs yu yu
2. Protect your patients
yu yu
3. Protect the Provider
yu yu
At which level of the Medicare Part A or Part B appeals process is the appeal decision by theOffice
yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu
of Medicare Hearings and Appeals (OMHA)?
yu yu yu yu yu
,a. first level of appeal
yu yu yu
b. second level of appeal yu yu yu
c. third level of appeal yu yu yu
d. fourth level of appeal yu yu yu
yu ✔✔c. . third level of appeal
yu yu yu yu yu
Frist level -yu yu
yu redetermination by Medicare contractor Second level - yu yu yu yu yu yu
reconsideration by Independent contractorThird appeal -
yu yu yu yu yu yu yu
yu Administrative Law Judge (ALJ) hearing Fourth appeal - yu yu yu yu yu yu yu
yu review by Medicare Appeals Council Fifth appeal -
yu yu yu yu yu yu yu
yu review in Federal District Court
yu yu yu yu
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.
yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu
a. Leadership skills. yu
b. Oversee the coding department. yu yu yu
c. Skills to design and implement a compliance program.
yu yu yu yu yu yu yu
d. Be able to anticipate new risk areas.
yu yu yu yu yu yu
e. Practical experience with documenting medical necessity.yu yu yu yu yu yu
✔✔a. Leadership skills, yu yu
,c. Skills to design and implement a compliance program, and
yu yu yu yu yu yu yu yu yu
d. Be able to anticipate new risk areas.
yu yu yu yu yu yu yu
Which of the following is an absolute necessity in order to have a successful Compliance
yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu
Program?
a. continuous training and improvements yu yu yu
b. effective reporting path yu yu
c. non-retaliation for whistle blowers yu yu
d. reliable and equal discipline yu yu yu yu
✔✔c. non-retaliation for whistle blowers
yu yu yu
A Compliance Program with well written policies and procedures:
yu yu yu yu yu yu yu yu
a. can be successful if consistently reviewed and maintained
yu yu yu yu yu yu yu
b. cannot be effective due to the sheer volume presented
yu yu yu yu yu yu yu yu
c. will be effective if read by management
yu yu yu yu yu yu
d. will not be successful without the proper oversight
yu yu yu yu yu yu yu yu
✔✔d. will not be successful without the
yu yu yu yu yu yu
proper oversight yu
A Compliance Officer can achieve a higher level of compliance and ethics engagement by:
yu yu yu yu yu yu yu yu yu yu yu yu yu
a. ensuring leadership reads the policies yu yu yu yu
, b. increasing management involvement yu yu
c. responding to compliance hotline calls yu yu yu yu
d. monitoring the code of conduct yu yu yu yu yu
✔✔b. increasing management involvement
yu yu yu
Which of the following requires providers to be permanently excluded from all federal healthcare
yu yu yu yu yu yu yu yu yu yu yu yu yu yu yu
programs if found guilty of a healthcare related fraud a third time:
yu yu yu yu yu yu yu yu yu yu yu
a. Deficit Reduction Act of 2005
yu yu yu yu
b. False Claims Act
yu yu
c. Balance Budget Act of 1997 yu yu yu yu
d. Social Security Act section 1128
yu yu yu yu
yu ✔✔c. Balance Budget Act of 1997
yu yu yu yu yu
Also known as a BBA "three strikes rule"
yu yu yu yu yu yu yu
Which statement is TRUE regarding compliance programs?
yu yu yu yu yu yu
a. Compliance programs are considered more dangerous if they are developed but notim
yu yu yu yu yu yu yu yu yu yu yu yu
plemented.
b. Compliance programs can detect but not prevent criminal conduct
yu yu yu yu yu yu yu yu
c. Compliance programs are only required by law for healthcare entities that have more than
yu yu yu yu yu yu yu yu yu yu yu yu yu
$500,000 in annual revenue. yu yu yu
