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

The Minimum Necessary Standard requires covered entities to make reasonable efforts to limit PHI use, disclosure, and requests to the minimum needed to accomplish the intended purpose.

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

CMS's Medicare Plan Finder Star Ratings uses a 1-to-5-star system to rate Medicare Advantage and Part D plans on quality and performance measures.

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

The CCD is an implementation guide built on HL7's Clinical Document Architecture (CDA) standard for sharing patient summary information.

Question 4

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

Accepted Answer

Department of Justice (DOJ)

Answer

The Department of Justice (DOJ) enforces the False Claims Act, which imposes civil liability on those who submit fraudulent claims to federal healthcare programs.

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

A spike in unspecified codes typically signals incomplete clinical documentation rather than fraud, indicating physicians did not document enough detail for coders to assign specific codes.

(HAC) Healthcare Analyst Certification Practice Test

(HAC) Healthcare Analyst Certification Practice Test

HAC Healthcare Analyst Systems & Regulations 2