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HCCA - CHPC STUDY QUESTIONS (MASTER FLASHCARDS) QUESTIONS AND ANSWERS
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HCCA - CHPC STUDY QUESTIONS (MASTER FLASHCARDS) QUESTIONS AND ANSWERS
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HCCA - CHPC STUDY QUESTIONS(MASTER FLASHCARDS) QUESTIONS
AND ANSWERS
WhatmismthempurposemofmHIPAA?m-mans✔✔•mProtectmPHImfrommunauthorizedmdisclosure/
use;
•mPreventmfraud,mwastemandmabusem(viamAdministrativemSimplification);
•mMakemhealthminsurancemportablemundermERISA;
•mMovemhealthmcaremontomamnationallymstandardizedmelectronicmbillingmplatform
Ref.mhttps://quizlet.com/6202453/hcca-chpc-overview-flash-cards/
MoremonmHIPAA:mhttps://www.hhs.gov/hipaa/index.html
HIPAAmresidesminmwhichmCFRmsection?m-
mans✔✔45mCFRmsectionsm164.102mthroughm164.534
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
WhatmaremthemsubpartsmofmHIPAAmpartm164?m-mans✔✔HIPAAm-m45mCFRm164,msubparts:
SubpartmAm-mGeneralmrules
SubpartmCm-mSecurity
SubpartmDm-mBreachmnotification
SubpartmEm-mPrivacy
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
Howmdomyoumdeterminemifmanmorganizationmismam"CoveredmEntity"?m-
mans✔✔1.mcomparemifmthemorganizationmmeetsmonemofmthem3mtypesmofmCEm(provider,mhealt
hmplan,mclearinghouse)
and
2.mdeterminemifmthemorganizationmelectronicallymtransmitsmonemofmthem9mdefinedmtransactio
ns:
•mHealthmclaimsmormequivalentmencounterminformation
•mHealthmclaimsmattachments
•mEnrollmentmandmdisenrollmentminmamhealthmplan
•mEligibilitymformamhealthmplan
•mHealthmcarempaymentmandmremittancemadvice
,•mHealthmplanmpremiummpayments
•mFirstmreportmofminjury
•mHealthmclaimmstatus
•mReferralmcertificationmandmauthorization
Inmaddition,mbusinessmassociatesmofmcoveredmentitiesmmustmfollowmpartsmofmthemHIPAAmreg
ulations.
https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
ThismActmestablishedminm1974mwasmcreatedmformgovernmentmagenciesmplacingmrestrictions
monmhowmthemgovernmentmcanmsharemtheminformationmmaintainedminmFederalmsystemsmofmr
ecordsmthatmmightminfringemonmanmindividual'smprivacymrightsmwithmothermindividualsmandma
gencies.m-mans✔✔ThemPrivacymActmofm1974
WhichmofmthemfollowingmismnotmconsideredmamHIPAAmEntitymDesignation:
1.mAffiliatedmcoveredmentity
2.mEntitymthatmperformsmhealthcaremandmnon-
healthcaremcomponentmactivitiesmincludingmbothmcoveredmandmnon-coveredmfunctions
3.mAmgroupmhealthmplan
4.mContractmarrangementmwithmFEDEXmcarrierm-
mans✔✔4.mContractmarrangementmwithmFEDEXmcarrier
WhatmismGramm-Leach-BlileymActm(GLBA)?m-mans✔✔Gramm-Leach-
BlileymActm(GLBA),malsomknownmasmthemFinancialmServicesmModernizationmActmofm1999,min
cludesmThemFinancialmPrivacymRulemandmThemSafeguardsmRulemrequiresmallmfinancialminsti
tutionsmtomprotectmcustomer'smpersonalmfinancialminformation.
WhatmismanmOHCA?m-
mans✔✔OHCAm(OrganizedmHealthmCaremArrangement) mit'smamclinicallymintegratedmcarems
ettingmwheremindividualsmreceivemhealthmcaremfrommmoremthanmonemprovider.m
Thesemaremjointmarrangements/
activitiesmandmhavemanmIntegratedmDeliverymSystemmformeasymexchangemofmPHImdata.mSee
m45mCFRm160.103.mOHCAsmcanmalsomutilizemamjointmNPP.mSeem45mCFRm§m164.520(d).
ACEm(AffiliatedmCoveredmEntity)mdomnotmhavemanmIntegratedmDeliverymSystemmbecausemth
esemaremlegallymseparatemcoveredmentitiesmthatmaremassociatedminmbusiness,mormaffiliatedm
asmamresultmofmsomemcommonmcontrolmormownership.
BothmthemOHCAmandmthemACEmwouldmallowmsharingmofmPHImacrossmparticipatingmentitymlin
esmformtreatment,mpayment,moperationsmpurposesm(TPO).
What'smanmACE?m-mans✔✔ACEm(AffiliatedmCoveredmEntity)
Legallymseparatemcoveredmentitiesmthatmsharemcommonmcontrol/
ownershipmandmdesignatemthemselvesmasmamsinglemCEmformthempurposemofmcomplyingmwit
hmthemHIPAAmPrivacymstandards.
,ACEsmdomnotmhavemanmIntegratedmDeliverymSystem,mwhilemOHCAmdo,mandmcanmsharemamsi
nglemNPP.mSeem45mCFRm§m164.520(d)
ACEmexample:mamhealthmsystemmcomposedmonmseveralmaffiliatedmhospitals.
BothmthemOHCAmandmthemACEmwouldmallowmsharingmofmPHImacrossmparticipatingmentitymlin
esmformtreatment,mpayment,moperationsmpurposesm(TPO).
What'smamHybridmEntity?m-
mans✔✔Entitymthatmconductsmbothmcoveredmfunctionsm(ormhealthcare-functions) mandmnon-
coveredmfunctionsm(othermbiz/non-healthcaremfunctions)mtomelectmtombemam"hybridmentity."
Forminstance,mamUniversitymSystemmthatmhasmamresearchmlaboratorymormacademicmmedical
mcenter.
Thempost-secondarymfunctionsm(non-
healthcaremcomponents)mdomNOTmneedmtomcomplymwithmHIPAA.
Themresearchmlab/
medmcentermfunctionsm(healthcaremcomponent)mneedsmtomcomplymwithmHIPAAmprovisionsm
tomprotectmthemuse/disclosuremofmPHIminvolved.
https://www.hhs.gov/hipaa/for-professionals/faq/315/when-does-a-covered-entity-have-
discretion-to-determine-covered-functions/index.html#:~:text=For%20example%2C
%20a%20hybrid%20entity,hybrid%20entity's%20health%20care%20component.
https://privacyruleandresearch.nih.gov/pr_06.asp
Themtransmissionmofminformationmbetweenmtwompartiesmtomcarrymoutmfinancialmormadministr
ativemactivitiesmrelatedmtomhealthmcaremismcalled:m-
mans✔✔Transactionm(healthcaremtransaction).
Fewmexamplesmofmhealthcaremtransactions:
healthcaremclaims;
coordinationmofmbenefits;
healthmplanmpremiummpayments;
remittancemadvicem(ormETF,melectronicmfundmtransfer);
referralmcertificationmandmauthorization
WhatmaremexamplesmofmamBA?m-mans✔✔BAm(BusinessmAssociate)m-
mperformsmfunctionsmormactivitiesmonmbehalfmofmamcoveredmentitymthatminvolvemaccessmbymth
embusinessmassociatemtomprotectedmhealthminformation.
Examples:
claimsmprocessing
datamanalysis
billing
benefitmmanagement
qualitymassurance
, qualitymimprovement
practicemmanagement
legal
actuarial
accounting
accreditation
othermadministrativemservices
https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/business-associates/
index.html
TruemormFalse:
Amhospitalmismnotmrequiredmtomhavemambusinessmassociatemcontractmwithmthemspecialistmtom
whommitmrefersmampatientmandmtransmitsmthempatient'smmedicalmchartmformtreatmentmpurpos
es.m-mans✔✔TRUE
Remember,musemandmdisclosuremofmPHImformpurposesmofmTPOmrequiresmnomspecificmautho
rization
TruemormFalse:
BusinessmAssociatesmAftermHITECH:
HITECHmmadembusinessmassociatesmdirectlymresponsiblemformHIPAAmcompliancemwithinmt
heirmindividualmbusinessesmthatmwouldmnotmotherwisembemsubjectmtomHIPAAmregulationsma
ndmpenaltiesm-mans✔✔TRUE
Evenmifmnomwrittenmcontractmexistsmbetweenmthemcoveredmentitymandmamcontractedmcompa
nymperformingmservicesmrelatedmtomhandlingmPHIminmsomemform,mthemcompanymismdeemedm
ambusinessmassociatembymlaw.mThismdeemedmstatusmessentiallymclassifiesmcontractedmven
dorsmormindividualsmasmbusinessmassociatesmsolelymbymthemnaturemofmthemservicesmtheympr
ovidemtomamcoveredmentity,mregardlessmofmwhethermtheymintendedmtombemclassifiedmasmbusi
nessmassociatesmormweremawaremofmtheirmstatusmasmsuch.mHIPAAmandmHITECHmmaymholdm
thesemvendorsmtombusinessmassociatemobligationsmasmlongmasmtheymactmasmbusinessmasso
ciates.
Likewise,mamsubcontractormthatmcreates,mreceives,mmaintains,mormtransmitsmPHImonmbehalf
mofmambusinessmassociatemismambusinessmassociate.mAmsubcontractormofmamsubcontractormi
smambusinessmassociatemasmwell,mandmsomonmdownmthemline.
Ref.m2023mHCCAmCompletemHealthcaremCompliancemManual
Ref.mHITECHmActmandmOCR'sm2013mfinalmrule
TruemormFalse:
UndermHIPAAmandmHITECH,mindividualsmormentitiesmwhomhavembeenmidentifiedmasmbusine
ssmassociatesmaremobligatedmtomentermintomambusinessmassociatemagreementmwithmtheirmco
ntractedmcoveredmentities.m-mans✔✔TRUE
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