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HCCA - CHPC Study Questions (MASTER FLASHCARDS) Questions and Correct Answers | Latest Update
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What is the purpose of HIPAA? ~~>• Protect PHI from unauthorized disclosure/use; • Prevent fraud, waste and abuse (via Administrative Simplification); • Make health insurance portable under ERISA; • Move health care onto a nationally standardized electronic billing platform Re...

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  • September 10, 2024
  • 139
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • hcca chpc study questions master flashcards q
  • what is the purpose of hipaa protect phi f

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1 | P a g e | © copyright 2024/2025 | Grade A+




HCCA - CHPC Study Questions (MASTER
FLASHCARDS) Questions and Correct
Answers | Latest Update
What is the purpose of HIPAA?


✓ ~~>• Protect PHI from unauthorized disclosure/use;

✓ • Prevent fraud, waste and abuse (via Administrative Simplification);

✓ • Make health insurance portable under ERISA;

✓ • Move health care onto a nationally standardized electronic billing

platform




Ref. https://quizlet.com/6202453/hcca-chpc-overview-flash-cards/


More on HIPAA: https://www.hhs.gov/hipaa/index.html




HIPAA resides in which CFR section?


✓ ~~>45 CFR sections 164.102 through 164.534




https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164




What are the subparts of HIPAA part 164?




Master01 | September, 2024/2025 | Latest update

, 2 | P a g e | © copyright 2024/2025 | Grade A+


✓ ~~>HIPAA - 45 CFR 164, subparts:

Subpart A - General rules


Subpart C - Security


Subpart D - Breach notification


Subpart E - Privacy




https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164




How do you determine if an organization is a "Covered Entity"?


✓ ~~>1. compare if the organization meets one of the 3 types of CE

(provider, health plan, clearinghouse)

and


2. determine if the organization electronically transmits one of the 9 defined

transactions:


• Health claims or equivalent encounter information


• Health claims attachments


• Enrollment and disenrollment in a health plan


• Eligibility for a health plan


• Health care payment and remittance advice


• Health plan premium payments


Master01 | September, 2024/2025 | Latest update

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• First report of injury


• Health claim status


• Referral certification and authorization




In addition, business associates of covered entities must follow parts of the

HIPAA regulations.


https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-

consumers/index.html




This Act established in 1974 was created for government agencies placing

restrictions on how the government can share the information maintained in

Federal systems of records that might infringe on an individual's privacy rights

with other individuals and agencies.


✓ ~~>The Privacy Act of 1974




Which of the following is not considered a HIPAA Entity Designation:


1. Affiliated covered entity


2. Entity that performs healthcare and non-healthcare component activities

including both covered and non-covered functions


3. A group health plan




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4. Contract arrangement with FEDEX carrier


✓ ~~>4. Contract arrangement with FEDEX carrier




What is Gramm-Leach-Bliley Act (GLBA)?


✓ ~~>Gramm-Leach-Bliley Act (GLBA), also known as the Financial

Services Modernization Act of 1999, includes The Financial Privacy Rule

and The Safeguards Rule requires all financial institutions to protect

customer's personal financial information.




What is an OHCA?


✓ ~~>OHCA (Organized Health Care Arrangement) it's a clinically

integrated care setting where individuals receive health care from

more than one provider.

These are joint arrangements/activities and have an Integrated Delivery

System for easy exchange of PHI data. See 45 CFR 160.103. OHCAs can also

utilize a joint NPP. See 45 CFR § 164.520(d).




ACE (Affiliated Covered Entity) do not have an Integrated Delivery System

because these are legally separate covered entities that are associated in

business, or affiliated as a result of some common control or ownership.




Master01 | September, 2024/2025 | Latest update

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