CHC EXAM 2024 WITH COMPLETE
QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
PPACA -Coverage - <<ANSWERS>>*Can't deny coverage to children under 19 due to preexisting
condition
*Can stay on parents coverage until 26
*Insurance can't rescind coverage due to honest mistake on application. Must provide 30 day notice
prior to cancelation
*Right to appeal denial through internal or external appeal. Insurer must provide info on appeal and
State Consumer Assistance Progrm
All annual financial reports must include an Internal Control Report stating that management is
responsible for an "adequate" internal control structure, and an assessment by management of the
effectiveness of the control structure. Any shortcomings in these controls must also be reported. In
addition, registered external auditors must attest to the accuracy of the company managements
assertion that internal acc
PPACA -Care - <<ANSWERS>>Care
Covers Preventive Care at No Cost to You: You may be eligible for recommended preventive health
services. No copayment.
Protects Your Choice of Doctors: Choose the primary care doctor you want from your plan's
network.
Removes Insurance Company Barriers to Emergency Services: You can seek emergency care at a
hospital outside of your health plan's network.
MHPAEA-"Mental Health Parity and Addiction Equity Act" - <<ANSWERS>>The Mental Health Parity
Act of 1996 (MHPA) provided that large group health plans cannot impose annual or lifetime dollar
limits on mental health benefits that are less favorable than any such limits imposed on
medical/surgical benefits.
, MIPPA-"Medicare Improvements for Patients and Providers 2008 - <<ANSWERS>>Strengthens part D
requirements, protection for beneficiaries, new marketing restrictions
Chapter 8 Federal Sentencing Guidelines (FSG) - <<ANSWERS>>Guidelines and policy in this section
apply to sentencing in federal criminal prosecution when the convicted defendant is an organization
FSG- 4 factors that increase ultimate punishment of an organization - <<ANSWERS>>1.Involvement
in or tolerance of criminal activity
2.Prior history of the organization
3.The violation of an order
4.The obstruction of justice
FSG- The two factors that mitigate the ultimate punishment of an organization - <<ANSWERS>>1.The
existence of an effective compliance and ethics program
2. Self-reporting,cooperation, or acceptance of responsibility
FSG - The 4 general principles - <<ANSWERS>>1. The court orders the organization to remedy harm
caused by the offense.
2.If the organization operated primary for a criminal purpose or primarily by criminal means the fine
should divest it of all assets.
3. Fine based on seriousness and culpability (6 factors)
4. Probation is appropriate when needed to ensure another sanction is fully implemented or to
ensure steps will be taken to reduce likelihood of future offense.
FSG-High-level personnel of the organization - <<ANSWERS>>Individuals who have substantial
control over the organization or who have a substantial role in the making of policy or has
substantial ownership interest
FSG-Substantial authority personnel - <<ANSWERS>>Individuals who within the scope of their
authority exercises substantial measure of discretion in acting on behalf of an organization.
Highlevel included in definition . Examples manager,can negotiate contracts or prices, supervisory
authority. No of these examples is required, determined on a case by case basis.
FSG-Condoned - <<ANSWERS>>If individual knew of the offense and didn't take reasonable steps to
prevent or terminate the offense.
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