HCCA CHC Exam Prep
HCCA - CHC STUDY QUESTIONS
(MASTER FLASHCARDS) 2026 – LATEST
QUESTIONS AND ANSWERS.
Stark or Physician Self-Referral Law -
Correct Answers -The Omnibus Budget Reconciliation Act bans
physicians from referring patients to receive "designated health
services" to any entity with which the physician has a financial
relationship. Designated health services include lab testing,
imaging services, physical or occupational therapy, etc. (civil
only, medicare/medicaid only, strict liability)
Anti-Kickback Statute (AKS) -
Correct Answers -Prohibits the solicitation, receiving, offering,
or paying any remuneration directly or indirectly in cash or in
kind in exchange. Essentially it prohibits the exchange of
anything of value in exchange for or in an effort to gain the
referral of business reimbursable by federal healthcare
programs. (intent, any federal program, civil or criminal)
Physician Payments Sunshine Act (PPSA) -
Correct Answers -Requires that detailed information about
payments or other "transfers of value" worth over $10 from
manufacturers of drugs, medical devices and biologics to
physicians and teaching hospitals be made available to the
public. (Open payment data).
Deficit Reduction Act -
Correct Answers -A Federal law that grants states the ability to
modify their Medicaid programs. This allows individual states to
reform their Medicaid programs to fit with the present health
care environment while maintaining federal guidelines.
False Claims Act -
1
, HCCA CHC Exam Prep
Correct Answers -Originally adopted byt U.S. Congress to
discourage suppliers from overcharging the government, it is
now legislation that prohibits anyone from knowingly
submitting or causing to be submitted a false or fraudulent
claim. DOJ.
Qui Tam Action -
Correct Answers -Allows persons and entities with evidence of
fraud against federal programs or contracts to sue the
wrongdoer on behalf of the United States Government - based
upon private information.
7 Elements of an Effective Compliance Program -
Correct Answers -1. Policies and Procedures
2. Compliance Oversight
3. Effective Lines of Communication
4. Training / Education
5. Internal Monitoring and Auditing
6. Enforcing standards through consistent disciplinary
guidelines
7. Responding timely to detracted offenses.
HIPAA Privacy Rule -
Correct Answers -A covered entity may not use of disclose
protected health information except for when it is required or
permitted.
HIPAA Security Rule -
Correct Answers -Essentially outlines how to protect PHI in an
electronic form (only applies to ePHI). 3 main safeguards:
administrative, technical, and physical.
Reportable Breach -
Correct Answers -1. breach of privacy rule
2. unsecured PHI
2
HCCA - CHC STUDY QUESTIONS
(MASTER FLASHCARDS) 2026 – LATEST
QUESTIONS AND ANSWERS.
Stark or Physician Self-Referral Law -
Correct Answers -The Omnibus Budget Reconciliation Act bans
physicians from referring patients to receive "designated health
services" to any entity with which the physician has a financial
relationship. Designated health services include lab testing,
imaging services, physical or occupational therapy, etc. (civil
only, medicare/medicaid only, strict liability)
Anti-Kickback Statute (AKS) -
Correct Answers -Prohibits the solicitation, receiving, offering,
or paying any remuneration directly or indirectly in cash or in
kind in exchange. Essentially it prohibits the exchange of
anything of value in exchange for or in an effort to gain the
referral of business reimbursable by federal healthcare
programs. (intent, any federal program, civil or criminal)
Physician Payments Sunshine Act (PPSA) -
Correct Answers -Requires that detailed information about
payments or other "transfers of value" worth over $10 from
manufacturers of drugs, medical devices and biologics to
physicians and teaching hospitals be made available to the
public. (Open payment data).
Deficit Reduction Act -
Correct Answers -A Federal law that grants states the ability to
modify their Medicaid programs. This allows individual states to
reform their Medicaid programs to fit with the present health
care environment while maintaining federal guidelines.
False Claims Act -
1
, HCCA CHC Exam Prep
Correct Answers -Originally adopted byt U.S. Congress to
discourage suppliers from overcharging the government, it is
now legislation that prohibits anyone from knowingly
submitting or causing to be submitted a false or fraudulent
claim. DOJ.
Qui Tam Action -
Correct Answers -Allows persons and entities with evidence of
fraud against federal programs or contracts to sue the
wrongdoer on behalf of the United States Government - based
upon private information.
7 Elements of an Effective Compliance Program -
Correct Answers -1. Policies and Procedures
2. Compliance Oversight
3. Effective Lines of Communication
4. Training / Education
5. Internal Monitoring and Auditing
6. Enforcing standards through consistent disciplinary
guidelines
7. Responding timely to detracted offenses.
HIPAA Privacy Rule -
Correct Answers -A covered entity may not use of disclose
protected health information except for when it is required or
permitted.
HIPAA Security Rule -
Correct Answers -Essentially outlines how to protect PHI in an
electronic form (only applies to ePHI). 3 main safeguards:
administrative, technical, and physical.
Reportable Breach -
Correct Answers -1. breach of privacy rule
2. unsecured PHI
2
