HCCA CHC/CHPC Exam Prep 2026–
2027 Latest Update | 600+ Actual
Practice Questions Collections with
Verified Answers and Rationales |
Complete Healthcare Compliance &
Privacy Certification Review | Mock
Exams, Case Scenarios and Study
Guide | Guaranteed Success
1. A healthcare compliance program is primarily designed to:
A. Increase revenue
B. Prevent, detect, and correct violations
C. Eliminate all risks
D. Replace legal counsel
✔ B. Prevent, detect, and correct violations (Correct Answer)
A compliance program focuses on identifying and mitigating regulatory risks while
ensuring adherence to laws and standards.
2. Which law established the False Claims Act liability for healthcare fraud?
A. HIPAA
B. Stark Law
C. False Claims Act
D. Anti-Kickback Statute
✔ C. False Claims Act (Correct Answer)
The False Claims Act imposes liability for knowingly submitting fraudulent claims to the
government.
3. The Office of Inspector General (OIG) primarily:
A. Licenses physicians
B. Enforces tax laws
C. Provides compliance guidance and oversight
D. Accredits hospitals
✔ C. Provides compliance guidance and oversight (Correct Answer)
OIG issues compliance program guidance and enforces fraud and abuse laws.
4. The Anti-Kickback Statute prohibits:
A. Billing errors
B. Paying for referrals
, C. Coding mistakes
D. Medical negligence
✔ B. Paying for referrals (Correct Answer)
It is illegal to knowingly offer or receive remuneration for referrals of federally funded
services.
5. HIPAA Privacy Rule protects:
A. Financial data only
B. Patient health information
C. Employee records only
D. Insurance contracts
✔ B. Patient health information (Correct Answer)
HIPAA ensures confidentiality and protection of identifiable health information.
6. A compliance officer should report directly to:
A. CFO
B. Legal counsel only
C. Board or senior leadership
D. HR manager
✔ C. Board or senior leadership (Correct Answer)
Independence and authority are essential for effective compliance oversight.
7. Stark Law regulates:
A. Billing fraud
B. Physician self-referrals
C. Patient privacy
D. Licensing
✔ B. Physician self-referrals (Correct Answer)
It prohibits physicians from referring patients to entities where they have a financial
interest.
8. Which element is NOT part of an effective compliance program?
A. Written policies
B. Training
C. Ignoring violations
D. Monitoring
✔ C. Ignoring violations (Correct Answer)
Failure to address violations undermines the compliance program.
9. What is “PHI”?
A. Public Health Index
B. Protected Health Information
C. Patient Health Insurance
D. Personal Hospital Identifier
✔ B. Protected Health Information (Correct Answer)
PHI includes identifiable health data protected under HIPAA.
10. Compliance training should be:
A. Optional
B. Annual and ongoing
C. Only for managers
D. Conducted once
, ✔ B. Annual and ongoing (Correct Answer)
Regular training ensures awareness of evolving regulations.
11. A whistleblower is:
A. A compliance officer
B. Someone reporting misconduct
C. A legal advisor
D. A regulator
✔ B. Someone reporting misconduct (Correct Answer)
Whistleblowers report violations and are protected under law.
12. The primary purpose of audits is to:
A. Punish staff
B. Identify compliance risks
C. Increase workload
D. Replace training
✔ B. Identify compliance risks (Correct Answer)
Audits help detect and prevent regulatory violations.
13. Which law addresses electronic PHI security?
A. Stark Law
B. HIPAA Security Rule
C. FCA
D. EMTALA
✔ B. HIPAA Security Rule (Correct Answer)
It sets standards for safeguarding electronic PHI.
14. EMTALA requires hospitals to:
A. Bill accurately
B. Provide emergency treatment
C. Report fraud
D. Protect data
✔ B. Provide emergency treatment (Correct Answer)
Hospitals must screen and stabilize emergency patients regardless of ability to pay.
15. A conflict of interest occurs when:
A. Policies are unclear
B. Personal interests influence decisions
C. Training is incomplete
D. Audits fail
✔ B. Personal interests influence decisions (Correct Answer)
Conflicts can compromise objectivity and ethical decision-making.
16. Compliance hotline should be:
A. Publicized and confidential
B. Hidden
C. Paid access
D. Limited
✔ A. Publicized and confidential (Correct Answer)
Encourages reporting without fear of retaliation.
, 17. Sanctions for noncompliance should be:
A. Ignored
B. Consistent and enforced
C. Optional
D. Confidential only
✔ B. Consistent and enforced (Correct Answer)
Fair enforcement ensures program credibility.
18. Risk assessment identifies:
A. Revenue streams
B. Compliance vulnerabilities
C. Staffing needs
D. Training budgets
✔ B. Compliance vulnerabilities (Correct Answer)
It prioritizes areas needing oversight.
19. Documentation must be:
A. Delayed
B. Accurate and timely
C. Minimal
D. Optional
✔ B. Accurate and timely (Correct Answer)
Proper documentation supports compliance and billing accuracy.
20. The False Claims Act includes:
A. Criminal penalties only
B. Civil penalties and treble damages
C. No penalties
D. Licensing restrictions
✔ B. Civil penalties and treble damages (Correct Answer)
Violators face significant financial penalties.
21. A compliance committee:
A. Replaces management
B. Supports compliance officer
C. Handles billing
D. Manages HR
✔ B. Supports compliance officer (Correct Answer)
Provides multidisciplinary oversight.
22. Retaliation against whistleblowers is:
A. Encouraged
B. Illegal
C. Optional
D. Ignored
✔ B. Illegal (Correct Answer)
Laws protect individuals who report violations.
23. Coding accuracy impacts:
A. Marketing
B. Billing compliance
C. Staffing
2027 Latest Update | 600+ Actual
Practice Questions Collections with
Verified Answers and Rationales |
Complete Healthcare Compliance &
Privacy Certification Review | Mock
Exams, Case Scenarios and Study
Guide | Guaranteed Success
1. A healthcare compliance program is primarily designed to:
A. Increase revenue
B. Prevent, detect, and correct violations
C. Eliminate all risks
D. Replace legal counsel
✔ B. Prevent, detect, and correct violations (Correct Answer)
A compliance program focuses on identifying and mitigating regulatory risks while
ensuring adherence to laws and standards.
2. Which law established the False Claims Act liability for healthcare fraud?
A. HIPAA
B. Stark Law
C. False Claims Act
D. Anti-Kickback Statute
✔ C. False Claims Act (Correct Answer)
The False Claims Act imposes liability for knowingly submitting fraudulent claims to the
government.
3. The Office of Inspector General (OIG) primarily:
A. Licenses physicians
B. Enforces tax laws
C. Provides compliance guidance and oversight
D. Accredits hospitals
✔ C. Provides compliance guidance and oversight (Correct Answer)
OIG issues compliance program guidance and enforces fraud and abuse laws.
4. The Anti-Kickback Statute prohibits:
A. Billing errors
B. Paying for referrals
, C. Coding mistakes
D. Medical negligence
✔ B. Paying for referrals (Correct Answer)
It is illegal to knowingly offer or receive remuneration for referrals of federally funded
services.
5. HIPAA Privacy Rule protects:
A. Financial data only
B. Patient health information
C. Employee records only
D. Insurance contracts
✔ B. Patient health information (Correct Answer)
HIPAA ensures confidentiality and protection of identifiable health information.
6. A compliance officer should report directly to:
A. CFO
B. Legal counsel only
C. Board or senior leadership
D. HR manager
✔ C. Board or senior leadership (Correct Answer)
Independence and authority are essential for effective compliance oversight.
7. Stark Law regulates:
A. Billing fraud
B. Physician self-referrals
C. Patient privacy
D. Licensing
✔ B. Physician self-referrals (Correct Answer)
It prohibits physicians from referring patients to entities where they have a financial
interest.
8. Which element is NOT part of an effective compliance program?
A. Written policies
B. Training
C. Ignoring violations
D. Monitoring
✔ C. Ignoring violations (Correct Answer)
Failure to address violations undermines the compliance program.
9. What is “PHI”?
A. Public Health Index
B. Protected Health Information
C. Patient Health Insurance
D. Personal Hospital Identifier
✔ B. Protected Health Information (Correct Answer)
PHI includes identifiable health data protected under HIPAA.
10. Compliance training should be:
A. Optional
B. Annual and ongoing
C. Only for managers
D. Conducted once
, ✔ B. Annual and ongoing (Correct Answer)
Regular training ensures awareness of evolving regulations.
11. A whistleblower is:
A. A compliance officer
B. Someone reporting misconduct
C. A legal advisor
D. A regulator
✔ B. Someone reporting misconduct (Correct Answer)
Whistleblowers report violations and are protected under law.
12. The primary purpose of audits is to:
A. Punish staff
B. Identify compliance risks
C. Increase workload
D. Replace training
✔ B. Identify compliance risks (Correct Answer)
Audits help detect and prevent regulatory violations.
13. Which law addresses electronic PHI security?
A. Stark Law
B. HIPAA Security Rule
C. FCA
D. EMTALA
✔ B. HIPAA Security Rule (Correct Answer)
It sets standards for safeguarding electronic PHI.
14. EMTALA requires hospitals to:
A. Bill accurately
B. Provide emergency treatment
C. Report fraud
D. Protect data
✔ B. Provide emergency treatment (Correct Answer)
Hospitals must screen and stabilize emergency patients regardless of ability to pay.
15. A conflict of interest occurs when:
A. Policies are unclear
B. Personal interests influence decisions
C. Training is incomplete
D. Audits fail
✔ B. Personal interests influence decisions (Correct Answer)
Conflicts can compromise objectivity and ethical decision-making.
16. Compliance hotline should be:
A. Publicized and confidential
B. Hidden
C. Paid access
D. Limited
✔ A. Publicized and confidential (Correct Answer)
Encourages reporting without fear of retaliation.
, 17. Sanctions for noncompliance should be:
A. Ignored
B. Consistent and enforced
C. Optional
D. Confidential only
✔ B. Consistent and enforced (Correct Answer)
Fair enforcement ensures program credibility.
18. Risk assessment identifies:
A. Revenue streams
B. Compliance vulnerabilities
C. Staffing needs
D. Training budgets
✔ B. Compliance vulnerabilities (Correct Answer)
It prioritizes areas needing oversight.
19. Documentation must be:
A. Delayed
B. Accurate and timely
C. Minimal
D. Optional
✔ B. Accurate and timely (Correct Answer)
Proper documentation supports compliance and billing accuracy.
20. The False Claims Act includes:
A. Criminal penalties only
B. Civil penalties and treble damages
C. No penalties
D. Licensing restrictions
✔ B. Civil penalties and treble damages (Correct Answer)
Violators face significant financial penalties.
21. A compliance committee:
A. Replaces management
B. Supports compliance officer
C. Handles billing
D. Manages HR
✔ B. Supports compliance officer (Correct Answer)
Provides multidisciplinary oversight.
22. Retaliation against whistleblowers is:
A. Encouraged
B. Illegal
C. Optional
D. Ignored
✔ B. Illegal (Correct Answer)
Laws protect individuals who report violations.
23. Coding accuracy impacts:
A. Marketing
B. Billing compliance
C. Staffing
