CHC Exam 2026 Questions and
Answers
PolicyA-
AAnswerAAAwrittenAdocumentAorAstatementAreflectingAstandardsAorArulesAthatAre
gulateAorAguideAorganizationalAactionAandAemployeeAconduct.
ProcedureA-AAnswerATheAprocessAfollowedAtoAcomplyAwithAaApolicy.
WorkAInstructionsA-AAnswerAStep-by-
stepsAinstructions,AincludingAinformationAandAequipmentAneededAtoAcompleteAaA
specificAtask.
ApproverA-
AAnswerATheApersonAorAdepartmentAwhoseAapprovalAisArequiredAtoAimplementAt
heApolicy.
PolicyAOwnerA-
AAnswerATheAindividualAorAdepartmentAresponsibleAforAtheAcontentAandAadminist
rationAofAtheApolicy.
SubjectAMatterAExpertA-
AAnswerAAApersonAwhoAhasAaAdeepAunderstandingAofAtheAtopicAandAprocess.
CodeAofAConductA-
AAnswerAAnAindustryAstandardAforAanAorganizationAtoAhaveAaAcodeAofAconductAt
hatAsetsAforthAtheAorganization'sAcommitmentAtoAcomplyAwithAapplicableAfederal
AandAstateAlaws,AincludingAlawsArelatedAtoAfraudAandAabuse.
CodeAofAConduct:AContentAChecklistA-
AAnswerALetterAfromAtheACEOA(orAtopAexecutive)
Organization'sAvalues
DefinitionAofAtheAcode,AincludingAitsApurposeAandAobjectives
QuestionsAandAAnswersAand/orAscenario-basedAexamplesAofArelevantAsituations
DetailsAonAreportingAmisconduct
Non-retaliationApromise
, OtherAresourcesA(suchAasApolicies,Aresources,Aetc.)
SevenAelementsAofAanAeffectiveAcomplianceAprogramA-
AAnswerA1.AimplementingAwrittenApolicies,Aprocedures,AandAstandardsAofAconduc
t.
2.ADesignatingAaAcomplianceAofficerAandAcomplianceAcommittee.
3.AConductingAeffectiveAtrainingAandAeducation.
4.ADevelopingAeffectiveAlinesAofAcommunication.
5.AConductingAinternalAmonitoringAandAauditing.
6.AEnforcingAstandardsAthroughAwell-publicizedAdisciplinaryAguidelines.
7.ARespondingApromptlyAtoAdetectedAoffensesAandAundertakingAcorrectiveAaction.
ResponsibleACorporateAOfficerADoctrineA-
AAnswerAAppliesAtoApersonsAholdingAaApositionAofAresponsibilityAandAauthorityAin
AanAorganizationAandAwhoApossessAtheAabilityAtoApreventAorAcorrectAaAviolation
AofAlaw.AAAcorporateAofficialAcanAbeAheldApersonallyAliableAforAcorporateAviolatio
ns.
TheAUSAFederalASentencingAGuidelinesA-
AAnswerAGuidelinesAsetAforthAforAprosecutorsAtoAconsiderAwhenAdeterminingAthe
AappropriateAformAofAresolutionAorAprosecution,AmonetaryApenalty,AandApotential
AcomplianceAobligationsAunderAaAcorporateAcriminalAresolution.
ExclusionsA-
AAnswerATheAHHSAOIGAcanAexcludeAorganizationsAfoundAtoAhaveAcommittedAhea
lthcareAfraudAandAabuseAfromAparticipatingAinAfederallyAfundedAhealthcareAprogr
ams.
NationalACommitteeAforAQualityAAssuranceA(NCQA)A-
AAnswerAAccreditsAhealthAplansAforAparticipationAinAMedicareAAdvantageAandAst
ateAMedicaidAmanagedAcareAprograms,AmanagedAbehavioralAhealthcareAorganizat
ions,Acredentials-verificationAorganizations,AandAphysicianAorganizations.
WhatAtwoAqualityAmeasureAframeworksAdoesANCQAAuseAtoAassessAitsAaccredited
Aorganizations?A-
AAnswerATheAHealthcareAEffectivenessADataAandAInformationASetA(HEDIS)AandAC
onsumerAAssessmentAofAHealthcareAProvidersAandASystemsA(CAHPS).
Answers
PolicyA-
AAnswerAAAwrittenAdocumentAorAstatementAreflectingAstandardsAorArulesAthatAre
gulateAorAguideAorganizationalAactionAandAemployeeAconduct.
ProcedureA-AAnswerATheAprocessAfollowedAtoAcomplyAwithAaApolicy.
WorkAInstructionsA-AAnswerAStep-by-
stepsAinstructions,AincludingAinformationAandAequipmentAneededAtoAcompleteAaA
specificAtask.
ApproverA-
AAnswerATheApersonAorAdepartmentAwhoseAapprovalAisArequiredAtoAimplementAt
heApolicy.
PolicyAOwnerA-
AAnswerATheAindividualAorAdepartmentAresponsibleAforAtheAcontentAandAadminist
rationAofAtheApolicy.
SubjectAMatterAExpertA-
AAnswerAAApersonAwhoAhasAaAdeepAunderstandingAofAtheAtopicAandAprocess.
CodeAofAConductA-
AAnswerAAnAindustryAstandardAforAanAorganizationAtoAhaveAaAcodeAofAconductAt
hatAsetsAforthAtheAorganization'sAcommitmentAtoAcomplyAwithAapplicableAfederal
AandAstateAlaws,AincludingAlawsArelatedAtoAfraudAandAabuse.
CodeAofAConduct:AContentAChecklistA-
AAnswerALetterAfromAtheACEOA(orAtopAexecutive)
Organization'sAvalues
DefinitionAofAtheAcode,AincludingAitsApurposeAandAobjectives
QuestionsAandAAnswersAand/orAscenario-basedAexamplesAofArelevantAsituations
DetailsAonAreportingAmisconduct
Non-retaliationApromise
, OtherAresourcesA(suchAasApolicies,Aresources,Aetc.)
SevenAelementsAofAanAeffectiveAcomplianceAprogramA-
AAnswerA1.AimplementingAwrittenApolicies,Aprocedures,AandAstandardsAofAconduc
t.
2.ADesignatingAaAcomplianceAofficerAandAcomplianceAcommittee.
3.AConductingAeffectiveAtrainingAandAeducation.
4.ADevelopingAeffectiveAlinesAofAcommunication.
5.AConductingAinternalAmonitoringAandAauditing.
6.AEnforcingAstandardsAthroughAwell-publicizedAdisciplinaryAguidelines.
7.ARespondingApromptlyAtoAdetectedAoffensesAandAundertakingAcorrectiveAaction.
ResponsibleACorporateAOfficerADoctrineA-
AAnswerAAppliesAtoApersonsAholdingAaApositionAofAresponsibilityAandAauthorityAin
AanAorganizationAandAwhoApossessAtheAabilityAtoApreventAorAcorrectAaAviolation
AofAlaw.AAAcorporateAofficialAcanAbeAheldApersonallyAliableAforAcorporateAviolatio
ns.
TheAUSAFederalASentencingAGuidelinesA-
AAnswerAGuidelinesAsetAforthAforAprosecutorsAtoAconsiderAwhenAdeterminingAthe
AappropriateAformAofAresolutionAorAprosecution,AmonetaryApenalty,AandApotential
AcomplianceAobligationsAunderAaAcorporateAcriminalAresolution.
ExclusionsA-
AAnswerATheAHHSAOIGAcanAexcludeAorganizationsAfoundAtoAhaveAcommittedAhea
lthcareAfraudAandAabuseAfromAparticipatingAinAfederallyAfundedAhealthcareAprogr
ams.
NationalACommitteeAforAQualityAAssuranceA(NCQA)A-
AAnswerAAccreditsAhealthAplansAforAparticipationAinAMedicareAAdvantageAandAst
ateAMedicaidAmanagedAcareAprograms,AmanagedAbehavioralAhealthcareAorganizat
ions,Acredentials-verificationAorganizations,AandAphysicianAorganizations.
WhatAtwoAqualityAmeasureAframeworksAdoesANCQAAuseAtoAassessAitsAaccredited
Aorganizations?A-
AAnswerATheAHealthcareAEffectivenessADataAandAInformationASetA(HEDIS)AandAC
onsumerAAssessmentAofAHealthcareAProvidersAandASystemsA(CAHPS).
