Healthcare Compliance
2025/2026
Exam Prep Guide
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, Healthcare Compliance - C807Compliance - C807
Healthcare
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1. HIPAA Health Insurance Portability and Accountability Act that protects patient health
information
2. HITECH Act Strengthens HIPAA by promoting electronic health records and increasing penal-
ties for breaches
3. Privacy Rule Part of HIPAA that protects the privacy of individually identifiable health information
4. Security Rule Part of HIPAA that requires appropriate administrative, physical, and technical
safeguards
5. Breach Notifica- Requires covered entities to notify individuals of a breach of unsecured PHI
tion Rule
6. Covered Entity Healthcare providers, plans, and clearinghouses that transmit health information
electronically
7. Business Associ- A person or entity that performs functions on behalf of a covered entity involving
ate PHI
8. Minimum Neces- Only the minimum amount of PHI needed should be used or disclosed
sary Standard
9. False Claims Act Prohibits submitting false or fraudulent claims to government healthcare programs
10. Qui Tam Provision in the False Claims Act that allows whistleblowers to sue on behalf of the
government
11. Anti-Kickback Prohibits offering or receiving anything of value for referrals in federal programs
Statute (AKS)
12. Stark Law Prohibits physician self-referral for Medicare/Medicaid patients if the physician
has a financial interest
13. Law that expands healthcare coverage and strengthens compliance requirements
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