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+.pdf

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m CHC STUDY QUESTIONS AND CORRECT ANSWERS (DE
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TAILED ANSWERS) | HCCA – m m m m




m CHC STUDY QUESTIONS ACTUAL EXAM (MASTER FLA
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SHCARDS) | 2024 UPDATE m m m




means the provision, coordination, or management of health care and
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related services by one or more health care providers, including the coordinatio
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n or management of health care by a health care provider with a third party; co
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nsultation between health care providers relating to a patient; or the referral of
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a patient for health care from one health care provider to another -
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m✔✔✔ ANSWER Treatment
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"...it cannot be emphasized enough that the only thing worse than not having
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a policy is having a policy and not following it." This statement refers to which
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of the Compliance Program Elements" -
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m✔✔✔ ANSWER Element 1: Standards, Policies and Procedures (a Code of Con
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duct).


Ref: SCCE Compliance & Ethics Program Manual, Chapter 2
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https://compliancecosmos.org/essential-elements-effective-ethics-and-
mcompliance-program
"Auditing and Monitoring have distinct differences. Explain -
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m✔✔✔ ANSWER Auditing - formalized, independent, objective process
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Monitoring - informal process, day-to- m m m m


day reviews, part of doing business, collaborative
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"He who brings the action for the king as well as for himself" -
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m✔✔✔ ANSWER Qui tam pro domino rege quam pro se ipso in hac parte sequitu
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r
"The privacy officer for a hospital has updated the Notice of Privacy Practices t
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o reflect a material change because the previous notice did not have a descrip
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tion that individuals have the right to amend their Protected Health Informatio
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n. The third party review team identified that the notice did not have the requ
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,ired

,information to let individuals know of their right to amend PHI. What's the BEST
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mcourse of action to correct deficiency?
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A. Make arrangements to have copies of the new NPP mailed to all patients see
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n within the last year at the hospital
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B. Make arrangements to have the new notice distributed to new patients that c
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ome to the hospital
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C. Post a copy of the new notice on the hospital's internal intranet so that all e
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mployees can see the updated version of the notice
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D. Meet with legal to discuss how to best self-
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disclose to the OCR that the hospital was in violation of the NPP requirements
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and has since - ✔✔✔ ANSWER
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B. Make arrangements to have the new notice distributed to new patients that c
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ome to the hospital
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Remember: The NPP must describe the following individual rights: https://www.l
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aw.cornell.edu/cfr/text/45/164.520
• The right to request restrictions on uses or disclosures of PHI for treatment,
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payment or healthcare operations; for use in a facility directory (if applicable);
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or to family members and others involved in the patient's care; however, the p
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rovider is not required to agree to the restriction except in the case of a disclos
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ure to a health insurer if the individual has paid for the care as required by
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§164.522(a)(1)(vi). This is a change necessitated by the Omnibus Rule. m m m m m m m m m




• The right to receive confidential communications by alternative means or at
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alternative locations per §164.522(b). m m m




• The right to inspect and copy PHI per § 164.524. The provider may want to in
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clude a statement that the provider may charge a reasonable cost-
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based fee for copies.
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• The right to amend PHI per § 164.526.
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• The right to receive an accounting of disclosures of PHI as provided by §
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164.528.

, • The right to receive a paper copy of the NPP upon request.
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• A brief description of how the individual may exercise the foregoing rights, e.g.,
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by submitting a written request to the provider's privacy officer.
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5 most important federal fraud and abuse laws -
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m✔✔✔ ANSWER FCA, AKS, Stark Law, CMPL, and Exclusion Authorities
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1984 Sentencing Reform Act -
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m✔✔✔ ANSWER Designed to correct inequities in deferral sentences. Includes th
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e Federal Sentencing Guidelines that include guidance for assessing fines and de
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tailed method for calculation of a "culpability score."
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2004 - Federal Sentencing Commission released "Ch 8 Part B -
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mRemedying Harm from Criminal Conduct, and Effective Compliance and Ethics P
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rogram" - m


m✔✔✔ ANSWER These revisions focused on effective compliance and ethics pro
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grams.
A billing manager is reviewing the monthly reimbursement report for the depart
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ment. The manager notices that there is an increase of 50% over the expected a
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mount of incoming payments from Federal health care programs for treatment
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of patients. The manager believes action is needed. The manager's NEXT step is
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to:
1. Stop all outgoing claims to Federal health care programs
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2. Extrapolate the last 6 months of reimbursement totals to identify th
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e overpayment due to health care programs
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3. Contact legal for next steps or further direction to include advice on how
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to proceed with the self disclosure protocol
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4. Analyze the details related to the increase in payments to identify possible s
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ources or causes for increase in reimbursement -
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m✔✔✔ ANSWER 4. Analyze the details related to the increase in payments to i
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dentify possible sources or causes for increase in reimbursement
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A breach is considered discovered when
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a. The moment a workforce member commits a breach
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b. When another person on the workforce is aware of the breach
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