C807 Healthcare Compliance

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Does your confidence disappear on test day? Keep it with our C807 Healthcare Compliance practice.

Free C807 Healthcare Compliance Questions

1.

Which of the following best describes the primary objectives of a risk management program in healthcare facilities?

  • To enhance patient satisfaction through improved service delivery

  • To ensure compliance with all federal and state regulations

  • To identify potential risks, prevent losses, and manage claims effectively

  • To streamline the billing process and improve revenue cycle management

Explanation

Explanation:

A risk management program in healthcare focuses on identifying, analyzing, and mitigating potential risks that could lead to patient harm, financial loss, or legal liability. Its primary objectives include preventing adverse events, ensuring patient and staff safety, minimizing organizational exposure to legal claims, and managing those claims efficiently when they occur. By proactively addressing potential threats, healthcare organizations can maintain high-quality care standards and protect both patients and assets.

Correct Answer:

To identify potential risks, prevent losses, and manage claims effectively


2.

What does it signify when a patient is issued a Receipt of Breach Notice by a healthcare provider?

  • The patient's medical records have been successfully updated.

  • The patient's protected health information has been compromised.

  • The patient has been enrolled in a new health insurance plan.

  • The patient is eligible for a refund on medical services.

Explanation

Explanation:

A Receipt of Breach Notice signifies that the patient's protected health information (PHI) has been compromised due to an unauthorized access, use, or disclosure of their data. Under the HIPAA Breach Notification Rule, covered entities are required to notify affected individuals when their PHI is breached. The notice includes details about the nature of the breach, the information involved, steps patients should take to protect themselves, and what the healthcare provider is doing to mitigate further risks.

Correct Answer:

The patient's protected health information has been compromised.


3.

Drug Diversion is a medical and legal concept involving the transfer of any legally prescribed controlled substance from the individual for whom it was prescribed to another person for any illicit use. As a prescriber and/or dispenser, you are required by the laws in the State of Oklahoma to guard against diversion.

  • Both statements are true

  • Both statements are false

  • Only first statement is true

  • Only second statement is true

Explanation

Explanation

Drug diversion refers to the illegal distribution or use of prescription medications, particularly controlled substances, for purposes other than those intended by the prescriber. This definition accurately captures the medical and legal implications of diversion. Additionally, prescribers and dispensers in Oklahoma, as in all U.S. states, are legally obligated to prevent diversion through responsible prescribing, recordkeeping, and monitoring. Therefore, both statements are accurate—the first defines the concept correctly, and the second accurately reflects the legal responsibility of healthcare professionals under Oklahoma law.

Correct Answer

Both statements are true


4.

What is the primary purpose of utilizing a cause-and-effect diagram in a healthcare setting?

  • To develop new treatment protocols for patients

  • To identify and analyze the root causes of specific problems affecting patient care

  • To create a financial budget for healthcare facilities

  • To evaluate the performance of healthcare staff

Explanation

Explanation

A cause-and-effect diagram, also known as a Fishbone diagram, is used in healthcare to systematically identify and analyze potential causes of a problem or adverse event. It helps teams organize factors that might contribute to errors, inefficiencies, or safety issues, such as staffing, processes, equipment, or communication. By visually mapping out these causes, healthcare organizations can target root causes for intervention, implement corrective measures, and improve patient care outcomes, quality, and safety.

Correct Answer

To identify and analyze the root causes of specific problems affecting patient care


5.

Under the HIPAA Privacy Rule, what is required of a covered entity when an individual requests access to their health information?

  • The covered entity must provide the information only in paper format

  • The covered entity must provide the information in the format requested if it is readily producible

  • The covered entity is not required to provide any information to the individual.

  • The covered entity must provide a summary of the health information instead of the full record.

Explanation

Explanation:

Under the HIPAA Privacy Rule, individuals have the right to access and obtain a copy of their protected health information (PHI) maintained by a covered entity. The covered entity must provide the requested information in the format and manner requested by the individual if it is readily producible in that format, whether electronic or paper. This provision ensures patients can easily access their records and use them for personal, legal, or medical purposes. Only if the requested format is not feasible may the entity provide an alternative format acceptable to the individual.

Correct Answer:

The covered entity must provide the information in the format requested if it is readily producible.


6.

Which of the following statements accurately describes the conditions under which breach notification requirements are triggered?

  • Breach notification is required for all types of PHI, regardless of security measures.

  • Breach notification applies only to unsecured PHI that remains accessible to unauthorized individuals.

  • Breach notification is necessary when PHI is encrypted and remains unreadable.

  • Breach notification is required for PHI that has been rendered unusable by technology.

Explanation

Explanation:

Breach notification requirements under HIPAA are triggered only when there is a breach involving unsecured protected health information (PHI). Unsecured PHI refers to data that has not been rendered unreadable, unusable, or indecipherable to unauthorized individuals through encryption or other approved security measures. If PHI is encrypted or otherwise secured, and a breach occurs but the data remains protected, notification is not required. Therefore, notifications are mandated only when unauthorized access to unsecured PHI could pose a privacy risk to individuals.

Correct Answer:

Breach notification applies only to unsecured PHI that remains accessible to unauthorized individuals.


7.

Emancipated minors _____.

  • Must be married to be declared emancipated by a court

  • Are under the custody of their parents

  • Are determined by federal law

  • Generally may authorize disclosure of their own PHI

Explanation

Explanation:

Emancipated minors are individuals under the age of 18 who have been granted legal independence from their parents or guardians by a court. This status allows them to make decisions that would normally require parental consent, including those related to healthcare and the disclosure of protected health information (PHI). While marriage is one potential basis for emancipation, it is not the only one—other conditions, such as military service or financial independence, may also qualify. Once emancipated, these minors generally have the same privacy rights over their medical information as adults.

Correct Answer:

Generally may authorize disclosure of their own PHI


8.

The HIPAA privacy rule requires covered entities to:

  • provide individuals with a notice of information practices.

  • refuse to treat noncompliant patient

  • provide individuals with copies of their records gratis

  • allow patients the right to view their health records.

Explanation

Explanation:

The Health Insurance Portability and Accountability Act (HIPAA) privacy rule establishes national standards to protect individuals’ medical records and personal health information. One key requirement is that covered entities, such as healthcare providers and insurers, must provide patients with a Notice of Privacy Practices. This notice informs individuals about how their information may be used or disclosed and outlines their rights regarding their health information, including access, amendment, and restriction requests.

Correct Answer:

provide individuals with a notice of information practices.


9.

A cause and effect diagram is a graphical tabular chart used to list and analyze the potential causes of a given problem; also known as what?

  • Fishbone diagram

  • Histogram

  • Check Sheet

  • Process map

Explanation

Explanation

A cause and effect diagram is a visual tool used to identify, explore, and display the possible causes of a specific problem or condition. It helps teams systematically analyze potential factors contributing to an issue by categorizing them, typically into groups such as methods, materials, manpower, and machines. Because the diagram resembles the skeleton of a fish with the problem statement at the “head” and causes branching off like “bones,” it is commonly referred to as a Fishbone diagram.

Correct Answer

Fishbone diagram


10.

Quantitative risk determination

  • ranks risk by likelihood of occurrence

  • ranks risk by amount of time needed to remediate

  • assigns monetary value to potential losses

  • ranks risks as low, medium, or high

Explanation

Explanation:

Quantitative risk determination is a method used in risk management that assigns numerical or monetary values to potential losses resulting from specific threats or vulnerabilities. This approach uses measurable data—such as the cost of an incident, frequency of occurrence, and impact—to calculate the expected financial exposure. It differs from qualitative assessment, which categorizes risks as low, medium, or high based on subjective judgment rather than exact figures.

Correct Answer:

assigns monetary value to potential losses


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