HCCA - CHC EXAM STUDY PACK 2026 –
d d d d d d d
ACTUAL EXAM QUESTIONS WITH 100% VERIFIED SOL
d d d d d d
UTIONS-LATEST UPDATE 2026-2027/A+ GRADE d d d
TruedordFalse:
d ThedACAdrequiresdthatdalldprovidersdadoptdadcompliancedplandasdadconditiondofdenrollmentdwithdMedi
care,dMedicaid,danddChildren'sdHealthdInsurancedProgramd(CHIP).
d ✔✔True
ref.dACAdsectiond6102
AccordingdtodHHS-OIGd-
d whatdaredthreedimportantdreasonsdfordproperddocumentationdindCompliance?d(hint:dprotections)
d ✔✔1.Protectdourdprograms
2. Protectdyourdpatients
3. ProtectdthedProvider
AtdwhichdleveldofdthedMedicaredPartdAdordPartdBdappealsdprocessdisdthedappealddecisiondbydthedOffi
cedofdMedicaredHearingsdanddAppealsd(OMHA)?
,a. firstdleveldofdappeal
b. seconddleveldofdappeal
c. thirddleveldofdappeal
d. fourthdleveldofdappeal
d ✔✔c.d.dthirddleveldofdappeal
Fristdleveld-
d redeterminationdbydMedicaredcontractordSeconddleveld-
reconsiderationdbydIndependentdcontractordThirddappeald-
d
d AdministrativedLawdJudged(ALJ)dhearingdFourthdappeald-
d reviewdbydMedicaredAppealsdCouncildFifthdappeald-
reviewdindFederaldDistrictdCourt
d
https://www.hhs.gov/about/agencies/omha/the-appeals-process/index.html
WhatdshoulddCCOdbedabledtoddo?d(Whatdskillsdshoulddthisdpersondhave?)dChoosedalldthatdapply.
a. Leadershipdskills.
b. Overseedthedcodingddepartment.
c. Skillsdtoddesigndanddimplementdadcompliancedprogram.
d. Bedabledtodanticipatednewdriskdareas.
e. Practicaldexperiencedwithddocumentingdmedicaldnecessity.d
✔✔a.dLeadershipdskills,
,c.dSkillsdtoddesigndanddimplementdadcompliancedprogram,dand
d.dBedabledtodanticipatednewdriskdareas.
WhichdofdthedfollowingdisdandabsolutednecessitydindorderdtodhavedadsuccessfuldCompliancedProgra
m?
a. continuousdtrainingdanddimprovements
b. effectivedreportingdpath
c. non-retaliationdfordwhistleblowers
d. reliabledanddequalddisciplined
✔✔c.dnon-retaliationdfordwhistleblowers
AdCompliancedProgramdwithdwelldwrittendpoliciesdanddprocedures:
a. candbedsuccessfuldifdconsistentlydrevieweddanddmaintained
b. cannotdbedeffectivedduedtodthedsheerdvolumedpresented
c. willdbedeffectivedifdreaddbydmanagement
d. willdnotdbedsuccessfuldwithoutdthedproperdoversightd
✔✔d.dwilldnotdbedsuccessfuldwithoutdthe
properdoversight
AdCompliancedOfficerdcandachievedadhigherdleveldofdcompliancedanddethicsdengagementdby:
a. ensuringdleadershipdreadsdthedpolicies
, b. increasingdmanagementdinvolvement
c. respondingdtodcompliancedhotlinedcalls
d. monitoringdthedcodedofdconductd
✔✔b.dincreasingdmanagementdinvolvement
Whichdofdthedfollowingdrequiresdprovidersdtodbedpermanentlydexcludeddfromdalldfederaldhealthdcar
edprogramsdifdfounddguiltydofdadhealthcaredrelateddfrauddadthirddtime:
a. DeficitdReductiondActdofd2005
b. FalsedClaimsdAct
c. BalancedBudgetdActdofd1997
d. SocialdSecuritydActdsectiond1128
d ✔✔c.dBalancedBudgetdActdofd1997
AlsodknowndasdadBBAd"threedstrikesdrule"
WhichdstatementdisdTRUEdregardingdcompliancedprograms?
a. Compliancedprogramsdaredconsidereddmoreddangerousdifdtheydareddevelopeddbutdnotdi
mplemented.
b. Compliancedprogramsdcanddetectdbutdnotdpreventdcriminaldconduct
c. Compliancedprogramsdaredonlydrequireddbydlawdfordhealthcaredentitiesdthatdhavedmoredthan
$500,000dindannualdrevenue.
d d d d d d d
ACTUAL EXAM QUESTIONS WITH 100% VERIFIED SOL
d d d d d d
UTIONS-LATEST UPDATE 2026-2027/A+ GRADE d d d
TruedordFalse:
d ThedACAdrequiresdthatdalldprovidersdadoptdadcompliancedplandasdadconditiondofdenrollmentdwithdMedi
care,dMedicaid,danddChildren'sdHealthdInsurancedProgramd(CHIP).
d ✔✔True
ref.dACAdsectiond6102
AccordingdtodHHS-OIGd-
d whatdaredthreedimportantdreasonsdfordproperddocumentationdindCompliance?d(hint:dprotections)
d ✔✔1.Protectdourdprograms
2. Protectdyourdpatients
3. ProtectdthedProvider
AtdwhichdleveldofdthedMedicaredPartdAdordPartdBdappealsdprocessdisdthedappealddecisiondbydthedOffi
cedofdMedicaredHearingsdanddAppealsd(OMHA)?
,a. firstdleveldofdappeal
b. seconddleveldofdappeal
c. thirddleveldofdappeal
d. fourthdleveldofdappeal
d ✔✔c.d.dthirddleveldofdappeal
Fristdleveld-
d redeterminationdbydMedicaredcontractordSeconddleveld-
reconsiderationdbydIndependentdcontractordThirddappeald-
d
d AdministrativedLawdJudged(ALJ)dhearingdFourthdappeald-
d reviewdbydMedicaredAppealsdCouncildFifthdappeald-
reviewdindFederaldDistrictdCourt
d
https://www.hhs.gov/about/agencies/omha/the-appeals-process/index.html
WhatdshoulddCCOdbedabledtoddo?d(Whatdskillsdshoulddthisdpersondhave?)dChoosedalldthatdapply.
a. Leadershipdskills.
b. Overseedthedcodingddepartment.
c. Skillsdtoddesigndanddimplementdadcompliancedprogram.
d. Bedabledtodanticipatednewdriskdareas.
e. Practicaldexperiencedwithddocumentingdmedicaldnecessity.d
✔✔a.dLeadershipdskills,
,c.dSkillsdtoddesigndanddimplementdadcompliancedprogram,dand
d.dBedabledtodanticipatednewdriskdareas.
WhichdofdthedfollowingdisdandabsolutednecessitydindorderdtodhavedadsuccessfuldCompliancedProgra
m?
a. continuousdtrainingdanddimprovements
b. effectivedreportingdpath
c. non-retaliationdfordwhistleblowers
d. reliabledanddequalddisciplined
✔✔c.dnon-retaliationdfordwhistleblowers
AdCompliancedProgramdwithdwelldwrittendpoliciesdanddprocedures:
a. candbedsuccessfuldifdconsistentlydrevieweddanddmaintained
b. cannotdbedeffectivedduedtodthedsheerdvolumedpresented
c. willdbedeffectivedifdreaddbydmanagement
d. willdnotdbedsuccessfuldwithoutdthedproperdoversightd
✔✔d.dwilldnotdbedsuccessfuldwithoutdthe
properdoversight
AdCompliancedOfficerdcandachievedadhigherdleveldofdcompliancedanddethicsdengagementdby:
a. ensuringdleadershipdreadsdthedpolicies
, b. increasingdmanagementdinvolvement
c. respondingdtodcompliancedhotlinedcalls
d. monitoringdthedcodedofdconductd
✔✔b.dincreasingdmanagementdinvolvement
Whichdofdthedfollowingdrequiresdprovidersdtodbedpermanentlydexcludeddfromdalldfederaldhealthdcar
edprogramsdifdfounddguiltydofdadhealthcaredrelateddfrauddadthirddtime:
a. DeficitdReductiondActdofd2005
b. FalsedClaimsdAct
c. BalancedBudgetdActdofd1997
d. SocialdSecuritydActdsectiond1128
d ✔✔c.dBalancedBudgetdActdofd1997
AlsodknowndasdadBBAd"threedstrikesdrule"
WhichdstatementdisdTRUEdregardingdcompliancedprograms?
a. Compliancedprogramsdaredconsidereddmoreddangerousdifdtheydareddevelopeddbutdnotdi
mplemented.
b. Compliancedprogramsdcanddetectdbutdnotdpreventdcriminaldconduct
c. Compliancedprogramsdaredonlydrequireddbydlawdfordhealthcaredentitiesdthatdhavedmoredthan
$500,000dindannualdrevenue.
