HCCA CHC Exam Prep 2025 update
Complete questions and verified
answers/100% accurate
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Terms in this set (75)
The Omnibus Budget Reconciliation
Act bans physicians from referring
patients to receive "designated health
services" to any entity with which the
Stark or Physician physician has a financial relationship.
Self-Referral Law Designated health services include
lab testing, imaging services, physical
or occupational therapy, etc. (civil
only, medicare/medicaid only, strict
liability)
, Prohibits the solicitation, receiving,
offering, or paying any remuneration
directly or indirectly in cash or in kind
in exchange. Essentially it prohibits
Anti-Kickback the exchange of anything of value in
Statute (AKS) exchange for or in an effort to gain
the referral of business reimbursable
by federal healthcare programs.
(intent, any federal program, civil or
criminal)
Requires that detailed information
about payments or other "transfers of
Physician value" worth over $10 from
Payments manufacturers of drugs, medical
Sunshine Act devices and biologics to physicians
(PPSA) and teaching hospitals be made
available to the public. (Open
payment data).
A Federal law that grants states the
ability to modify their Medicaid
programs. This allows individual states
Deficit Reduction
to reform their Medicaid programs to
Act
fit with the present health care
environment while maintaining federal
guidelines.
, Originally adopted byt U.S. Congress
to discourage suppliers from
overcharging the government, it is
False Claims Act now legislation that prohibits anyone
from knowingly submitting or causing
to be submitted a false or fraudulent
claim. DOJ.
Allows persons and entities with
evidence of fraud against federal
programs or contracts to sue the
Qui Tam Action
wrongdoer on behalf of the United
States Government - based upon
private information.
1. Policies and Procedures
2. Compliance Oversight
3. Effective Lines of Communication
7 Elements of an
4. Training / Education
Effective
5. Internal Monitoring and Auditing
Compliance
6. Enforcing standards through
Program
consistent disciplinary guidelines
7. Responding timely to detracted
offenses.
A covered entity may not use of
HIPAA Privacy disclose protected health information
Rule except for when it is required or
permitted.
Complete questions and verified
answers/100% accurate
answers|already graded A+
Save
Terms in this set (75)
The Omnibus Budget Reconciliation
Act bans physicians from referring
patients to receive "designated health
services" to any entity with which the
Stark or Physician physician has a financial relationship.
Self-Referral Law Designated health services include
lab testing, imaging services, physical
or occupational therapy, etc. (civil
only, medicare/medicaid only, strict
liability)
, Prohibits the solicitation, receiving,
offering, or paying any remuneration
directly or indirectly in cash or in kind
in exchange. Essentially it prohibits
Anti-Kickback the exchange of anything of value in
Statute (AKS) exchange for or in an effort to gain
the referral of business reimbursable
by federal healthcare programs.
(intent, any federal program, civil or
criminal)
Requires that detailed information
about payments or other "transfers of
Physician value" worth over $10 from
Payments manufacturers of drugs, medical
Sunshine Act devices and biologics to physicians
(PPSA) and teaching hospitals be made
available to the public. (Open
payment data).
A Federal law that grants states the
ability to modify their Medicaid
programs. This allows individual states
Deficit Reduction
to reform their Medicaid programs to
Act
fit with the present health care
environment while maintaining federal
guidelines.
, Originally adopted byt U.S. Congress
to discourage suppliers from
overcharging the government, it is
False Claims Act now legislation that prohibits anyone
from knowingly submitting or causing
to be submitted a false or fraudulent
claim. DOJ.
Allows persons and entities with
evidence of fraud against federal
programs or contracts to sue the
Qui Tam Action
wrongdoer on behalf of the United
States Government - based upon
private information.
1. Policies and Procedures
2. Compliance Oversight
3. Effective Lines of Communication
7 Elements of an
4. Training / Education
Effective
5. Internal Monitoring and Auditing
Compliance
6. Enforcing standards through
Program
consistent disciplinary guidelines
7. Responding timely to detracted
offenses.
A covered entity may not use of
HIPAA Privacy disclose protected health information
Rule except for when it is required or
permitted.
