HCCA CHC Exam Prep questions and
with correct answers
StarkHorHPhysicianHSelf-ReferralHLawH-HCORRECTHANSWER-
TheHOmnibusHBudgetHReconciliationHActHbansHphysiciansHfromHreferringHpatientsHtoHreceiveH"desi
gnatedHhealthHservices"HtoHanyHentityHwithHwhichHtheHphysicianHhasHaHfinancialHrelationship.HDesi
gnatedHhealthHservicesHincludeHlabHtesting,HimagingHservices,HphysicalHorHoccupationalHtherapy,He
tc.H(civilHonly,Hmedicare/medicaidHonly,HstrictHliability)
Anti-KickbackHStatuteH(AKS)H-HCORRECTHANSWER-
ProhibitsHtheHsolicitation,Hreceiving,Hoffering,HorHpayingHanyHremunerationHdirectlyHorHindirectlyHi
nHcashHorHinHkindHinHexchange.HEssentiallyHitHprohibitsHtheHexchangeHofHanythingHofHvalueHinHexcha
ngeHforHorHinHanHeffortHtoHgainHtheHreferralHofHbusinessHreimbursableHbyHfederalHhealthcareHprogr
ams.H(intent,HanyHfederalHprogram,HcivilHorHcriminal)
PhysicianHPaymentsHSunshineHActH(PPSA)H-HCORRECTHANSWER-
RequiresHthatHdetailedHinformationHaboutHpaymentsHorHotherH"transfersHofHvalue"HworthHoverH$1
0HfromHmanufacturersHofHdrugs,HmedicalHdevicesHandHbiologicsHtoHphysiciansHandHteachingHhospit
alsHbeHmadeHavailableHtoHtheHpublic.H(OpenHpaymentHdata).
DeficitHReductionHActH-HCORRECTHANSWER-
AHFederalHlawHthatHgrantsHstatesHtheHabilityHtoHmodifyHtheirHMedicaidHprograms.HThisHallowsHindiv
idualHstatesHtoHreformHtheirHMedicaidHprogramsHtoHfitHwithHtheHpresentHhealthHcareHenvironmentH
whileHmaintainingHfederalHguidelines.
FalseHClaimsHActH-HCORRECTHANSWER-
OriginallyHadoptedHbytHU.S.HCongressHtoHdiscourageHsuppliersHfromHoverchargingHtheHgovernmen
t,HitHisHnowHlegislationHthatHprohibitsHanyoneHfromHknowinglyHsubmittingHorHcausingHtoHbeHsubmit
tedHaHfalseHorHfraudulentHclaim.HDOJ.
, QuiHTamHActionH-HCORRECTHANSWER-
AllowsHpersonsHandHentitiesHwithHevidenceHofHfraudHagainstHfederalHprogramsHorHcontractsHtoHsue
HtheHwrongdoerHonHbehalfHofHtheHUnitedHStatesHGovernmentH-HbasedHuponHprivateHinformation.
7HElementsHofHanHEffectiveHComplianceHProgramH-HCORRECTHANSWER-1.HPoliciesHandHProceduresH
2.HComplianceHOversight
3.HEffectiveHLinesHofHCommunicationH
4.HTrainingH/HEducationH
5.HInternalHMonitoringHandHAuditingH
6.HEnforcingHstandardsHthroughHconsistentHdisciplinaryHguidelinesH
7.HRespondingHtimelyHtoHdetractedHoffenses.
HIPAAHPrivacyHRuleH-HCORRECTHANSWER-
AHcoveredHentityHmayHnotHuseHofHdiscloseHprotectedHhealthHinformationHexceptHforHwhenHitHisHreq
uiredHorHpermitted.
HIPAAHSecurityHRuleH-HCORRECTHANSWER-
EssentiallyHoutlinesHhowHtoHprotectHPHIHinHanHelectronicHformH(onlyHappliesHtoHePHI).H3HmainHsafe
guards:Hadministrative,Htechnical,HandHphysical.
ReportableHBreachH-HCORRECTHANSWER-1.HbreachHofHprivacyHrule
2.HunsecuredHPHIH
3.HmoreHthanH"lowHprobabilityHofHcompromise"
BreachHNotificationH-HCORRECTHANSWER-1.HNotifyHindividualHinHwritingH
-ifHlessHthanH10HareHundeliverable,HalternateHnotificationHmethodH(likeHemail)HmayHbeHuseH
-ifHmoreHthanH10HareHundeliverable,HmustHpostHcontactHinfoHtoHwebHpage.H
with correct answers
StarkHorHPhysicianHSelf-ReferralHLawH-HCORRECTHANSWER-
TheHOmnibusHBudgetHReconciliationHActHbansHphysiciansHfromHreferringHpatientsHtoHreceiveH"desi
gnatedHhealthHservices"HtoHanyHentityHwithHwhichHtheHphysicianHhasHaHfinancialHrelationship.HDesi
gnatedHhealthHservicesHincludeHlabHtesting,HimagingHservices,HphysicalHorHoccupationalHtherapy,He
tc.H(civilHonly,Hmedicare/medicaidHonly,HstrictHliability)
Anti-KickbackHStatuteH(AKS)H-HCORRECTHANSWER-
ProhibitsHtheHsolicitation,Hreceiving,Hoffering,HorHpayingHanyHremunerationHdirectlyHorHindirectlyHi
nHcashHorHinHkindHinHexchange.HEssentiallyHitHprohibitsHtheHexchangeHofHanythingHofHvalueHinHexcha
ngeHforHorHinHanHeffortHtoHgainHtheHreferralHofHbusinessHreimbursableHbyHfederalHhealthcareHprogr
ams.H(intent,HanyHfederalHprogram,HcivilHorHcriminal)
PhysicianHPaymentsHSunshineHActH(PPSA)H-HCORRECTHANSWER-
RequiresHthatHdetailedHinformationHaboutHpaymentsHorHotherH"transfersHofHvalue"HworthHoverH$1
0HfromHmanufacturersHofHdrugs,HmedicalHdevicesHandHbiologicsHtoHphysiciansHandHteachingHhospit
alsHbeHmadeHavailableHtoHtheHpublic.H(OpenHpaymentHdata).
DeficitHReductionHActH-HCORRECTHANSWER-
AHFederalHlawHthatHgrantsHstatesHtheHabilityHtoHmodifyHtheirHMedicaidHprograms.HThisHallowsHindiv
idualHstatesHtoHreformHtheirHMedicaidHprogramsHtoHfitHwithHtheHpresentHhealthHcareHenvironmentH
whileHmaintainingHfederalHguidelines.
FalseHClaimsHActH-HCORRECTHANSWER-
OriginallyHadoptedHbytHU.S.HCongressHtoHdiscourageHsuppliersHfromHoverchargingHtheHgovernmen
t,HitHisHnowHlegislationHthatHprohibitsHanyoneHfromHknowinglyHsubmittingHorHcausingHtoHbeHsubmit
tedHaHfalseHorHfraudulentHclaim.HDOJ.
, QuiHTamHActionH-HCORRECTHANSWER-
AllowsHpersonsHandHentitiesHwithHevidenceHofHfraudHagainstHfederalHprogramsHorHcontractsHtoHsue
HtheHwrongdoerHonHbehalfHofHtheHUnitedHStatesHGovernmentH-HbasedHuponHprivateHinformation.
7HElementsHofHanHEffectiveHComplianceHProgramH-HCORRECTHANSWER-1.HPoliciesHandHProceduresH
2.HComplianceHOversight
3.HEffectiveHLinesHofHCommunicationH
4.HTrainingH/HEducationH
5.HInternalHMonitoringHandHAuditingH
6.HEnforcingHstandardsHthroughHconsistentHdisciplinaryHguidelinesH
7.HRespondingHtimelyHtoHdetractedHoffenses.
HIPAAHPrivacyHRuleH-HCORRECTHANSWER-
AHcoveredHentityHmayHnotHuseHofHdiscloseHprotectedHhealthHinformationHexceptHforHwhenHitHisHreq
uiredHorHpermitted.
HIPAAHSecurityHRuleH-HCORRECTHANSWER-
EssentiallyHoutlinesHhowHtoHprotectHPHIHinHanHelectronicHformH(onlyHappliesHtoHePHI).H3HmainHsafe
guards:Hadministrative,Htechnical,HandHphysical.
ReportableHBreachH-HCORRECTHANSWER-1.HbreachHofHprivacyHrule
2.HunsecuredHPHIH
3.HmoreHthanH"lowHprobabilityHofHcompromise"
BreachHNotificationH-HCORRECTHANSWER-1.HNotifyHindividualHinHwritingH
-ifHlessHthanH10HareHundeliverable,HalternateHnotificationHmethodH(likeHemail)HmayHbeHuseH
-ifHmoreHthanH10HareHundeliverable,HmustHpostHcontactHinfoHtoHwebHpage.H
