AAPC HIPAA & Healthcare Compliance Regulations 1 — Questions and Answers
Question 1: What does the acronym HIPAA stand for?
- Health Insurance Portability and Accountability Act (Correct answer)
- Healthcare Information Privacy and Access Act
- Hospital Insurance Payment and Authorization Act
- Health Information Protection and Audit Act
Correct answer: Health Insurance Portability and Accountability Act
HIPAA stands for the Health Insurance Portability and Accountability Act of 1996, which established national standards for protecting health information.
Question 2: Which of the following is an example of Protected Health Information (PHI) under HIPAA?
- General public health statistics
- A patient's name combined with their diagnosis and date of service (Correct answer)
- De-identified aggregate data
- Published clinical research results
Correct answer: A patient's name combined with their diagnosis and date of service
PHI is any individually identifiable health information that relates to a person's past, present, or future health, healthcare, or payment for care.
Question 3: What does the HIPAA Privacy Rule primarily govern?
- Electronic transaction standards
- The use and disclosure of individuals' health information by covered entities (Correct answer)
- Security of electronic health records only
- Medicare billing requirements
Correct answer: The use and disclosure of individuals' health information by covered entities
The HIPAA Privacy Rule establishes national standards for protecting PHI and gives patients rights over their health information.
Question 4: What is a Business Associate Agreement (BAA) under HIPAA?
- A billing contract between providers
- A contract between a covered entity and a vendor who handles PHI on its behalf (Correct answer)
- An employment agreement for billing staff
- A payer network participation agreement
Correct answer: A contract between a covered entity and a vendor who handles PHI on its behalf
A BAA is a legally required contract that establishes how a business associate may use and safeguard PHI received from a covered entity.
Question 5: What does the HIPAA Security Rule specifically protect?
- Paper medical records only
- Electronic Protected Health Information (ePHI) (Correct answer)
- Verbal communications between providers
- Insurance claim forms
Correct answer: Electronic Protected Health Information (ePHI)
The HIPAA Security Rule requires covered entities to implement administrative, physical, and technical safeguards to protect the confidentiality and integrity of ePHI.
Question 6: Under HIPAA, what constitutes a 'breach'?
- Filing a claim with incorrect codes
- An impermissible use or disclosure of unsecured PHI that compromises its privacy or security (Correct answer)
- Failing to collect a co-pay
- Submitting a late claim
Correct answer: An impermissible use or disclosure of unsecured PHI that compromises its privacy or security
A HIPAA breach is an unauthorized acquisition, access, use, or disclosure of unsecured PHI that is not permitted under the Privacy Rule.
AAPC HIPAA & Healthcare Compliance Regulations 1
What does the acronym HIPAA stand for?