Regulatory Reporting & Data Governance 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 Regulatory Reporting & Data Governance flashcards as text
CMS's Merit-based Incentive Payment System (MIPS) consolidates four legacy programs. Which of the following was NOT one of them?
Answer: Hospital Inpatient Quality Reporting (IQR)
MIPS consolidated PQRS, VBPM, and the EHR Incentive Program (Meaningful Use)—the IQR program is a separate hospital-focused program not part of MIPS.
A data governance framework requires that all PHI used in analytics be classified. Which classification tier would apply to a dataset containing only zip codes and diagnosis codes with no other identifiers?
Answer: Limited dataset — requires a data use agreement (DUA)
Under HIPAA, a limited dataset retains certain indirect identifiers (like zip codes and dates) but removes direct identifiers, and its use requires a DUA.
Which regulatory body oversees the accuracy of ICD-10-CM/PCS coding that underlies much of inpatient regulatory reporting and reimbursement?
Answer: CMS and CDC jointly through the ICD-10 Coordination and Maintenance Committee
CMS and CDC jointly maintain ICD-10-CM/PCS coding through the ICD-10 Coordination and Maintenance Committee, which updates codes annually.
In data governance maturity models (such as CMMI for Data Management), an organization at 'Level 3 — Defined' is characterized by:
Answer: Standardized, documented data governance processes applied consistently across the organization
Maturity Level 3 (Defined) means governance processes are documented, standardized, and applied consistently organization-wide rather than only in isolated pockets.
A healthcare analytics team is preparing the annual CMS Cost Report (Form 2552-10). Which cost allocation method is typically required to distribute overhead costs to patient care cost centers?
Answer: Step-down (sequential) cost allocation method
CMS requires the step-down cost allocation method for Medicare Cost Reports, systematically distributing overhead from non-revenue to revenue-producing cost centers.
Under GDPR, which principle most directly applies when a US healthcare analytics firm processes data of EU residents participating in a clinical trial?
Answer: Purpose limitation — data collected for trial use cannot be repurposed without separate consent
Purpose limitation under GDPR prohibits using personal data for purposes incompatible with the original specified purpose without obtaining new consent.
Which healthcare data governance control is most effective at preventing 'data drift' — the gradual, uncontrolled divergence of data definitions across systems over time?
Answer: Implementing a change management process requiring governance approval for data definition modifications
A formal change management process requiring governance committee approval before altering data definitions prevents unauthorized drift across systems.