HCCA CHC/CHPC COMPLIANCE EXAM
Certified in Healthcare Compliance (CHC) / Certified in
Healthcare Privacy Compliance (CHPC) |
Updated Questions & Answers With Rationale
A+ GRADED| BRAND NEW RELEASE!
This comprehensive examination is designed to evaluate the knowledge and
competency of healthcare compliance professionals preparing for the HCCA CHC and
CHPC certifications. The content aligns with the current HCCA exam outline and reflects
the latest regulatory updates. The exam focuses on compliance program structure, risk
assessment, auditing and monitoring, investigations, education, regulatory requirements
(False Claims Act, Anti-Kickback, Stark), privacy and security (HIPAA, HITECH), and
program effectiveness. Emphasis is placed on understanding the practical application of
compliance principles in a healthcare setting.
DOMAINS COVERED:
1. Compliance Program Structure and Governance
2. Standards, Policies, and Procedures
3. Risk Assessment and Risk Management
4. Auditing and Monitoring
5. Investigations and Reporting
6. Education, Training, and Communication
7. Healthcare Regulatory Compliance
8. Privacy and Security Compliance
9. Privacy Program Administration
10. Program Effectiveness and Remediation
,1. A healthcare organization is designing a compliance program and wants to
ensure the compliance officer can independently identify and escalate significant
risks. Which structural feature is MOST important?
A. Reporting exclusively to the chief financial officer
B. Independent access to the governing body
C. Reporting only through department managers
D. Limiting compliance reviews to financial matters
Answer: B
Rationale: An effective compliance function requires sufficient independence,
authority, and access to governance so significant concerns can be escalated without
inappropriate operational interference.
2. Which responsibility BEST reflects the role of a governing board in an effective
healthcare compliance program?
A. Conducting every compliance investigation personally
B. Approving individual employee disciplinary actions
C. Providing oversight of compliance program effectiveness
D. Performing daily coding audits for the organization
Answer: C
Rationale: Governance is responsible for oversight, including understanding major
compliance risks, receiving meaningful reports, and ensuring the organization
maintains an effective compliance program.
3. A compliance officer discovers that several departments have developed
conflicting policies addressing the same regulatory requirement. What should the
compliance officer do FIRST?
A. Immediately discipline the department managers
,B. Determine the applicable requirement and assess the conflicting policies
C. Delete all departmental policies
D. Report the organization immediately to law enforcement
Answer: B
Rationale: The first step is to understand the regulatory requirement and determine
how the conflicting policies create risk before deciding on remediation.
4. Which characteristic is MOST important when developing a healthcare
organization's code of conduct?
A. It should address only federal criminal laws
B. It should reflect organizational values and expected ethical behavior
C. It should be written exclusively for compliance personnel
D. It should focus exclusively on financial performance
Answer: B
Rationale: A code of conduct should communicate ethical standards, organizational
values, responsibilities, and expected behavior across the organization.
5. A compliance department is preparing its annual work plan. Which approach is
MOST appropriate for determining which compliance activities receive priority?
A. Selecting topics alphabetically
B. Prioritizing based on identified compliance risks
C. Selecting only issues requested by employees
D. Auditing only areas that were reviewed last year
Answer: B
, Rationale: Risk-based planning allows compliance resources to focus on areas
presenting the greatest potential legal, regulatory, financial, operational, or
reputational exposure.
6. A hospital wants to determine whether its compliance program is actually
reducing identified risks. Which activity would provide the BEST evidence?
A. Counting the number of compliance policies
B. Measuring program effectiveness using defined metrics
C. Increasing the length of the employee handbook
D. Holding more meetings without measuring outcomes
Answer: B
Rationale: Effectiveness should be evaluated through meaningful measures such as
audit results, reporting trends, training outcomes, corrective actions, and risk
reduction.
7. An employee reports suspected improper billing through the organization's
compliance hotline. What should happen NEXT?
A. The report should automatically be dismissed if anonymous
B. The concern should be appropriately documented, assessed, and investigated
C. The employee should be required to confront the billing manager
D. The allegation should immediately be disclosed publicly
Answer: B
Rationale: All reports, including anonymous ones, must be documented, assessed,
and investigated according to the organization's investigation protocols.
8. What is the primary purpose of a compliance program?
Certified in Healthcare Compliance (CHC) / Certified in
Healthcare Privacy Compliance (CHPC) |
Updated Questions & Answers With Rationale
A+ GRADED| BRAND NEW RELEASE!
This comprehensive examination is designed to evaluate the knowledge and
competency of healthcare compliance professionals preparing for the HCCA CHC and
CHPC certifications. The content aligns with the current HCCA exam outline and reflects
the latest regulatory updates. The exam focuses on compliance program structure, risk
assessment, auditing and monitoring, investigations, education, regulatory requirements
(False Claims Act, Anti-Kickback, Stark), privacy and security (HIPAA, HITECH), and
program effectiveness. Emphasis is placed on understanding the practical application of
compliance principles in a healthcare setting.
DOMAINS COVERED:
1. Compliance Program Structure and Governance
2. Standards, Policies, and Procedures
3. Risk Assessment and Risk Management
4. Auditing and Monitoring
5. Investigations and Reporting
6. Education, Training, and Communication
7. Healthcare Regulatory Compliance
8. Privacy and Security Compliance
9. Privacy Program Administration
10. Program Effectiveness and Remediation
,1. A healthcare organization is designing a compliance program and wants to
ensure the compliance officer can independently identify and escalate significant
risks. Which structural feature is MOST important?
A. Reporting exclusively to the chief financial officer
B. Independent access to the governing body
C. Reporting only through department managers
D. Limiting compliance reviews to financial matters
Answer: B
Rationale: An effective compliance function requires sufficient independence,
authority, and access to governance so significant concerns can be escalated without
inappropriate operational interference.
2. Which responsibility BEST reflects the role of a governing board in an effective
healthcare compliance program?
A. Conducting every compliance investigation personally
B. Approving individual employee disciplinary actions
C. Providing oversight of compliance program effectiveness
D. Performing daily coding audits for the organization
Answer: C
Rationale: Governance is responsible for oversight, including understanding major
compliance risks, receiving meaningful reports, and ensuring the organization
maintains an effective compliance program.
3. A compliance officer discovers that several departments have developed
conflicting policies addressing the same regulatory requirement. What should the
compliance officer do FIRST?
A. Immediately discipline the department managers
,B. Determine the applicable requirement and assess the conflicting policies
C. Delete all departmental policies
D. Report the organization immediately to law enforcement
Answer: B
Rationale: The first step is to understand the regulatory requirement and determine
how the conflicting policies create risk before deciding on remediation.
4. Which characteristic is MOST important when developing a healthcare
organization's code of conduct?
A. It should address only federal criminal laws
B. It should reflect organizational values and expected ethical behavior
C. It should be written exclusively for compliance personnel
D. It should focus exclusively on financial performance
Answer: B
Rationale: A code of conduct should communicate ethical standards, organizational
values, responsibilities, and expected behavior across the organization.
5. A compliance department is preparing its annual work plan. Which approach is
MOST appropriate for determining which compliance activities receive priority?
A. Selecting topics alphabetically
B. Prioritizing based on identified compliance risks
C. Selecting only issues requested by employees
D. Auditing only areas that were reviewed last year
Answer: B
, Rationale: Risk-based planning allows compliance resources to focus on areas
presenting the greatest potential legal, regulatory, financial, operational, or
reputational exposure.
6. A hospital wants to determine whether its compliance program is actually
reducing identified risks. Which activity would provide the BEST evidence?
A. Counting the number of compliance policies
B. Measuring program effectiveness using defined metrics
C. Increasing the length of the employee handbook
D. Holding more meetings without measuring outcomes
Answer: B
Rationale: Effectiveness should be evaluated through meaningful measures such as
audit results, reporting trends, training outcomes, corrective actions, and risk
reduction.
7. An employee reports suspected improper billing through the organization's
compliance hotline. What should happen NEXT?
A. The report should automatically be dismissed if anonymous
B. The concern should be appropriately documented, assessed, and investigated
C. The employee should be required to confront the billing manager
D. The allegation should immediately be disclosed publicly
Answer: B
Rationale: All reports, including anonymous ones, must be documented, assessed,
and investigated according to the organization's investigation protocols.
8. What is the primary purpose of a compliance program?
