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HCCA - CHPC Study Questions and Answers (2022/2023) Already Passed $12.99   Add to cart

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HCCA - CHPC Study Questions and Answers (2022/2023) Already Passed

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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 Ref. More on H...

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  • November 7, 2023
  • 117
  • 2023/2024
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  • HCCA - CHPC Study
  • HCCA - CHPC Study
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HCCA - CHPC Study Questions and
Answers (2022/2023) Already Passed
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? ✔✔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

• 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


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.




Both the OHCA and the ACE would allow sharing of PHI across participating entity lines for

treatment, payment, operations purposes (TPO).




What's an ACE? ✔✔ACE (Affiliated Covered Entity)


Legally separate covered entities that share common control/ownership and designate themselves

as a single CE for the purpose of complying with the HIPAA Privacy standards.

ACEs do not have an Integrated Delivery System, while OHCA do, and can share a single NPP.

See 45 CFR § 164.520(d)




ACE example: a health system composed on several affiliated hospitals.

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