HCCA - CHPC Exam Prep 2025 Update
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What date did HIPAA 1996
became law
1. Protect individuals' PHI
What is the purpose of
2. Promote high quality healthcare
HIPAA?
3. Protect the public's health and well being
HIPAA resides in what 45 CFR sections 164.102 through 164.534
CFR section
Section One: 164.102 - 164.318 and 164.530 - 164-534
Organizational Requirements
Section Two: 164.500 - 164.514 Use and Disclosure of
Identify the four sections Information
in the CFR by location
and topic Section Three: 164.520 - 164.528 Individual's Rights
and Penalties
Section Four: Interaction with the HIPAA Security
Rule
How do you determine if compare the functions of the entity to the three
organization is a CE principal types of "covered entities" (CE)
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- Provider
What are the different - Health Plan
types of CEs - Clearing House
- Other Types
Supports medical or health services such as SNFs,
How is a Provider
home health, hospitals, physician clinics, etc that
defined
transmit in electronic form
Does a provider need a No, a provider does not need a standing facility to
standing facility to be be considered a CE
considered a CE
(1) A healthcare organization that provides or pays
the cost of medical care
What is a Health Plan
(2) Includes Medicaid, Medicare, and self funded
plans
(1) processes health information from a nonstandard
data elements of health information into standard
data
elements
What is a Clearinghouse
(2) includes billing services, health information
systems, etc
(3) does NOT include Third Party Administrations (
TPAs)
What are the three Organized Health Care Arrangement (OHCA)
Organizational Affiliated Covered Entities (ACE)
Arrangements Hybrid Covered Entity (HCE)
What is a Hybrid Covered single covered entity with non-health care
Entity (HCE) components
What is an Organized clinically integrated care setting where individuals
Health Care Arrangement receive health care from more than one covered
(OHCA)? entity
(1) legally separate covered entities that share
common control or common ownership
What is an Affiliated
(2) choose to designate themselves as one affiliated
Covered Entity (ACE)?
CE for the purposes of complying with the HIPAA
Privacy standard
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What must a Affiliated Be treated as a single CE. Must agree to follow a
Entity agree to? standard policy and procedure
(1) Separate entity working on behalf of the CE
providing Treatment, Payment, and Healthcare
What is a Business Operations (TPO) and/or associated activities
Associate? requiring access and/or will create, receive,
maintain, and/or transmit PHI
(2) Must have a business associate agreement
(1) Workforce: employees, volunteers, trainees, and
others under control of the CE
Who is allowed to access (2) Business Associates: Separate entity working on
PHI? behalf of the CE providing Treatment, Payment, and
Healthcare Operations (TPO) and/or associated
activities requiring access and/or use of PHI
claims processing
data analysis
billing
benefit management
quality assurance
What is an example of a quality improvement
BA? practice management
legal
actuarial
accounting
accreditation
other administrative services
What has been the main - lack of penalties for non-compliance
complaint with holding a - federal penalties could only be levied against the
BA accountable under CE
the 2000 Privacy Rule?
Which new regulation Health Information Technology
corrected shortcomings for Economic and Clinical Health (HITECH)
of the HIPAA 2000
regulation concerning
BAs?
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