HCCA CHC/CHPC COMPLIANCE
PRACTICE EXAM 2026/2027 QUESTIONS
AND ANSWERS LATEST UPDATE THIS
YEAR - JUST RELEASED
1. Under the Federal Sentencing Guidelines for Organizations (FSGO), what is the primary
purpose of establishing an effective compliance and ethics program?
A. To guarantee that no employees will ever violate federal law.
B. To exercise due diligence to prevent and detect criminal conduct.
C. To increase the organization’s market share through ethical branding.
D. To replace the need for internal audits and financial monitoring.
Answer: B
Conceptual Explanation: The FSGO states that an organization must exercise due
diligence to prevent and detect criminal conduct and otherwise promote an organizational
culture that encourages ethical conduct.
2. According to the OIG, which of the following is considered a core element of a healthcare
compliance program?
A. Annual mandatory vacations for all C-suite executives.
B. A minimum of 40 hours of legal training for all staff.
,C. Designation of a compliance officer and compliance committee.
D. Automatic termination for any billing error found during an audit.
Answer: C
Conceptual Explanation: The OIG lists seven elements, one of which is the designation of a
compliance officer and a compliance committee to provide oversight.
3. The False Claims Act (FCA) imposes liability on any person who knowingly presents a false
or fraudulent claim for payment. What does ‘knowingly’ encompass under the FCA?
A. Actual knowledge, deliberate ignorance, or reckless disregard.
B. Only actual knowledge of the information.
C. Specific intent to defraud the government is required.
D. Accidental clerical errors made by entry-level staff.
Answer: A
Conceptual Explanation: The FCA defines ‘knowingly’ to include actual knowledge,
deliberate ignorance of the truth, or reckless disregard for the truth; no specific intent to
defraud is required.
4. Which federal statute prohibits the exchange of anything of value in an effort to induce or
reward the referral of federal healthcare program business?
A. The Stark Law
B. The Anti-Kickback Statute (AKS)
, C. The Sherman Antitrust Act
D. The Emergency Medical Treatment and Labor Act (EMTALA)
Answer: B
Conceptual Explanation: The AKS is a criminal statute that prohibits the exchange of
remuneration to induce or reward referrals of items or services reimbursable by a Federal
health care program.
5. A physician refers a Medicare patient for physical therapy to a clinic in which the
physician’s immediate family member has an ownership interest. This may violate which law?
A. Anti-Kickback Statute
B. The Stark Law (Physician Self-Referral Law)
C. False Claims Act
D. HIPAA Privacy Rule
Answer: B
Conceptual Explanation: The Stark Law prohibits a physician from making referrals for
certain designated health services (DHS) to an entity with which he or she (or an
immediate family member) has a financial relationship, unless an exception applies.
6. What is the standard for reporting a breach under the HIPAA Breach Notification Rule
when the breach involves fewer than 500 individuals?
A. Notify the Secretary of HHS within 60 days of discovery.
PRACTICE EXAM 2026/2027 QUESTIONS
AND ANSWERS LATEST UPDATE THIS
YEAR - JUST RELEASED
1. Under the Federal Sentencing Guidelines for Organizations (FSGO), what is the primary
purpose of establishing an effective compliance and ethics program?
A. To guarantee that no employees will ever violate federal law.
B. To exercise due diligence to prevent and detect criminal conduct.
C. To increase the organization’s market share through ethical branding.
D. To replace the need for internal audits and financial monitoring.
Answer: B
Conceptual Explanation: The FSGO states that an organization must exercise due
diligence to prevent and detect criminal conduct and otherwise promote an organizational
culture that encourages ethical conduct.
2. According to the OIG, which of the following is considered a core element of a healthcare
compliance program?
A. Annual mandatory vacations for all C-suite executives.
B. A minimum of 40 hours of legal training for all staff.
,C. Designation of a compliance officer and compliance committee.
D. Automatic termination for any billing error found during an audit.
Answer: C
Conceptual Explanation: The OIG lists seven elements, one of which is the designation of a
compliance officer and a compliance committee to provide oversight.
3. The False Claims Act (FCA) imposes liability on any person who knowingly presents a false
or fraudulent claim for payment. What does ‘knowingly’ encompass under the FCA?
A. Actual knowledge, deliberate ignorance, or reckless disregard.
B. Only actual knowledge of the information.
C. Specific intent to defraud the government is required.
D. Accidental clerical errors made by entry-level staff.
Answer: A
Conceptual Explanation: The FCA defines ‘knowingly’ to include actual knowledge,
deliberate ignorance of the truth, or reckless disregard for the truth; no specific intent to
defraud is required.
4. Which federal statute prohibits the exchange of anything of value in an effort to induce or
reward the referral of federal healthcare program business?
A. The Stark Law
B. The Anti-Kickback Statute (AKS)
, C. The Sherman Antitrust Act
D. The Emergency Medical Treatment and Labor Act (EMTALA)
Answer: B
Conceptual Explanation: The AKS is a criminal statute that prohibits the exchange of
remuneration to induce or reward referrals of items or services reimbursable by a Federal
health care program.
5. A physician refers a Medicare patient for physical therapy to a clinic in which the
physician’s immediate family member has an ownership interest. This may violate which law?
A. Anti-Kickback Statute
B. The Stark Law (Physician Self-Referral Law)
C. False Claims Act
D. HIPAA Privacy Rule
Answer: B
Conceptual Explanation: The Stark Law prohibits a physician from making referrals for
certain designated health services (DHS) to an entity with which he or she (or an
immediate family member) has a financial relationship, unless an exception applies.
6. What is the standard for reporting a breach under the HIPAA Breach Notification Rule
when the breach involves fewer than 500 individuals?
A. Notify the Secretary of HHS within 60 days of discovery.
