HAC Healthcare Analyst Systems & Regulations 2

Question 1

Under HIPAA's Minimum Necessary Standard, a covered entity must limit PHI disclosures to the:

Accepted Answer

Minimum amount reasonably needed to accomplish the intended purpose

Answer

Entire patient record upon any request

Answer

Amount specified by the requesting provider regardless of purpose

Answer

Full dataset available in the EHR system

Question 2

Which CMS program uses a 5-star quality rating system for Medicare Advantage and Part D plans?

Accepted Answer

Medicare Plan Finder Star Ratings

Answer

Hospital Compare

Answer

Physician Compare

Answer

HEDIS Benchmarks

Question 3

In an EHR system, a Continuity of Care Document (CCD) is based on which standard?

Accepted Answer

HL7 CDA (Clinical Document Architecture)

Answer

HL7 FHIR R4

Answer

ANSI X12 837

Answer

NCPDP SCRIPT

Question 4

Which regulatory body enforces the False Claims Act in healthcare fraud cases?

Accepted Answer

Department of Justice (DOJ)

Answer

The Joint Commission

Answer

CMS Office of Inspector General (OIG)

Answer

State Insurance Commission

Question 5

A healthcare analyst notices a sudden spike in ED visits coded as 'chest pain unspecified.' Which data quality issue does this most likely indicate?

Accepted Answer

Lack of specificity or incomplete clinical documentation

Answer

Upcoding for higher reimbursement

Answer

Undercoding due to coder fatigue

Answer

Intentional DRG manipulation

Question 6

In value-based care, a Hierarchical Condition Category (HCC) model is primarily used to:

Accepted Answer

Risk-adjust per-member-per-month capitation payments

Answer

Set episode-of-care bundled payment rates

Answer

Calculate hospital DRG weights

Answer

Determine pharmacy benefit tiers

Question 7

Which provision of the 21st Century Cures Act specifically prohibits practices that unreasonably restrict access to electronic health information?

Accepted Answer

The Anti-Information Blocking Rule

Answer

Meaningful Use Stage 3

Answer

HIPAA Security Rule Amendment

Answer

Stark Law Safe Harbor