Healthcare Analytics Policy & Compliance Flashcards
7 cards from real HAC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Healthcare Analytics Policy & Compliance flashcards as text
The ONC's Information Blocking Rule prohibits healthcare actors from interfering with the access, exchange, or use of electronic health information (EHI). Which entity is NOT considered a regulated 'actor' under this rule?
Answer: Individual patients requesting their own records
Individual patients are the intended beneficiaries of the Information Blocking Rule, not regulated actors subject to its prohibitions.
Under the Medicare Conditions of Participation, hospitals must retain medical records for at least:
Answer: 5 years from the date of discharge or 3 years after a minor reaches age 18
CMS Conditions of Participation require hospitals to retain patient records for at least 5 years, or 3 years after a minor patient reaches age 18, whichever is longer.
A healthcare analytics vendor is classified as a HIPAA Business Associate when it:
Answer: Creates, receives, maintains, or transmits PHI on behalf of a covered entity to perform a service
A business associate is any entity that performs functions or activities involving PHI on behalf of a covered entity, triggering the need for a Business Associate Agreement (BAA).
The Federal Anti-Kickback Statute (AKS) in healthcare prohibits:
Answer: Offering remuneration to induce referrals for services covered by federal healthcare programs
The AKS prohibits knowingly offering, paying, soliciting, or receiving anything of value to induce or reward referrals of items or services covered by federal healthcare programs.
When a healthcare organization performs a HIPAA Security Risk Assessment, the analysis must cover:
Answer: All electronic PHI (ePHI) that the organization creates, receives, maintains, or transmits
The HIPAA Security Risk Assessment must evaluate all ePHI regardless of where it is stored or transmitted, including cloud, mobile, and third-party systems.
The Stark Law (Physician Self-Referral Law) primarily prohibits:
Answer: Physicians from referring Medicare/Medicaid patients to entities in which the physician has a financial relationship, absent an exception
Stark Law is a strict liability statute that prohibits physician self-referrals to designated health service entities where the physician has a direct or indirect financial relationship, unless a specific exception applies.
Under the False Claims Act, the 'qui tam' provision allows:
Answer: Private individuals (whistleblowers) to file lawsuits on behalf of the government and share in recovered funds
The qui tam provision enables private whistleblowers (relators) to file False Claims Act suits on behalf of the government and receive 15–30% of any recovered funds.