HCCA- CHC EXAM, PRACTICE EXAM AND STUDY GUIDE NEWEST 2024 ACTUAL EXAM 500+ QUESTIONS AND CORRECT DETAILED ANSWERS WITH EXPLANATIONS (VERIFIED ANSWERS) |ALREADY GRADED A+

1 | P a g e

HCCA- CHC EXAM, PRACTICE EXAM AND STUDY

GUIDE NEWEST 2024 ACTUAL EXAM 500+

QUESTIONS AND CORRECT DETAILED ANSWERS

WITH EXPLANATIONS (VERIFIED ANSWERS)

|ALREADY GRADED A+

HCCA- CHC EXAM

What is the term called for an organization's commitment to compliance

by the board, management, and employees? It summarizes ethical

behavior and legal principles the healthcare organization operates.

A) Code of Conduct

B) Federal Sentencing Guidelines

C) Internal Controls - ANSWER- A) Code of Conduct

The U.S. Federal Sentencing Commission was organized in _____,

published its initial set of guidelines in _____, and

included chapter eight of the Federal Sentencing Guidelines for

Organizations (FSGO) in _____.

a. 1980, 1987, 1999

b. 1985, 1987, 1991

c. 1980, 1985, 1987

d. 1985, 1990, 2001 - ANSWER- b. 1985, 1987, 1991

2 | P a g e

"The privacy officer for a hospital has updated the Notice of Privacy

Practices to reflect a material change because the previous notice did not

have a description that individuals have the right to amend their

Protected Health Information. The third party review team identified that

the notice did not have the required information to let individuals know

of their right to amend PHI. What's the BEST course of action to correct

deficiency?

A. Make arrangements to have copies of the new NPP mailed to all

patients seen within the last year at the hospital

B. Make arrangements to have the new notice distributed to new patients

that come to the hospital

C. Post a copy of the new notice on the hospital's internal intranet so that

all employees can see the updated version of the notice

D. Meet with legal to discuss how to best self-disclose to the OCR that

the hospital was in violation of the NPP requirements and has since -

ANSWER- B. Make arrangements to have the new notice distributed to

new patients that come to the hospital

Remember: The NPP must describe the following individual rights:

https://www.law.cornell.edu/cfr/text/45/164.520

• The right to request restrictions on uses or disclosures of PHI for

treatment, payment or healthcare operations; for use in a facility

directory (if applicable); or to family members and others involved in

the patient's care; however, the provider is not required to agree to the

restriction except in the case of a disclosure to a health insurer if the

individual has paid for the care as required by

§164.522(a)(1)(vi). This is a change necessitated by the Omnibus Rule.

• The right to receive confidential communications by alternative means

or at alternative locations per §164.522(b).

3 | P a g e

• The right to inspect and copy PHI per § 164.524. The provider may

want to include a statement that the provider may charge a reasonable

cost-based fee for copies.

• The right to amend PHI per § 164.526.

• The right to receive an accounting of disclosures of PHI as provided by

§ 164.528.

• The right to receive a paper copy of the NPP upon request.

• A brief description of how the individual may exercise the foregoing

rights, e.g., by submitting a written request to the provider's privacy

officer.

What is the best definition of Medicare/Medicaid fraud?

a. Attempting a scheme against the Medicare/Medicaid program

b. Knowingly executing a scheme against the Medicare/Medicaid

program

c. Willfully executing a scheme against the Medicare/Medicaid program

d. All of the above - ANSWER- d. All of the above

Remember: Fraud is generally defined as knowingly and willfully

executing, or attempting to execute, a scheme.

FRAUD is intentional;

WASTE is overuse/misuse of resources carelessly;

ABUSE on the other hand, does not require poof of intent, but it's

improper practice leading to unnecessary expenses

4 | P a g e

What is the best definition of Medicare/Medicaid abuse?

a. Knowingly defrauding the Medicare/Medicaid program

b. Intentionally violating Medicare/Medicaid guidelines

c. Unknowingly violating Medicare/Medicaid guidelines

d. None of the above - ANSWER- c. Unknowingly violating

Medicare/Medicaid guidelines

FRAUD is intentional (knowingly/willfully);

WASTE is overuse/misuse of resources carelessly;

ABUSE on the other hand, does not require poof of intent, but it's

improper practice leading to unnecessary expenses

A provider intentionally upcodes services to a higher level in order to

receive a larger reimbursement from Medicare/Medicaid. Is this

violation fraud, abuse, or neither?

a. Fraud

b. Abuse

c. Neither - ANSWER- a. Fraud

Upcoding - is a type of fraud (knowing/intentionally) coding more

expensive codes for higher reimbursement

What is true about Medicaid Integrity Programs:

a. established by the DRA of 2005

b. federally administered and state monitored