HAC Healthcare Policy & Legislation 3

Question 1

Which federal agency is responsible for enforcing HIPAA Privacy and Security Rules?

Accepted Answer

Office for Civil Rights (OCR) within the Department of Health and Human Services

Answer

The OCR is the primary federal agency tasked with investigating HIPAA complaints and enforcing the Privacy and Security Rules against covered entities and business associates.

Question 2

A healthcare organization's compliance program should include all of the following elements recommended by the OIG EXCEPT:

Accepted Answer

Guaranteed immunity from federal prosecution for all compliance violations discovered internally

Answer

The OIG's model compliance program elements do not include immunity from prosecution; a compliance program can mitigate risk but does not guarantee immunity.

Question 3

Under HIPAA's Minimum Necessary standard, covered entities must:

Accepted Answer

Limit the use and disclosure of PHI to the minimum amount needed to accomplish the intended purpose

Answer

The Minimum Necessary standard requires covered entities to make reasonable efforts to limit PHI access and disclosure to what is needed for a specific purpose.

Question 4

The Balanced Budget Act of 1997 significantly affected Medicare by:

Accepted Answer

Creating the Medicare+Choice program (later renamed Medicare Advantage) and introducing prospective payment for home health

Answer

The BBA of 1997 introduced Medicare+Choice to expand managed care options and implemented prospective payment systems for post-acute care including home health agencies.

Question 5

Which of the following best describes 'value-based purchasing' in CMS payment reform?

Accepted Answer

Tying a portion of provider reimbursement to quality and efficiency metrics rather than paying purely for volume of services

Answer

Value-based purchasing programs reward providers financially for delivering high-quality, efficient care, shifting payment from fee-for-service volume to outcomes-based performance.

(HAC) Healthcare Analyst Certification Practice Test

(HAC) Healthcare Analyst Certification Practice Test

HAC Healthcare Policy & Legislation 3