FREE AND STUDY GAMES ABOUT HIPAA RULES EXAM

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FREE AND STUDY GAMES ABOUT HIPAA RULES EXAM

QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

This Exam contains:

-Guarantee passing score -85 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation Question 1: To what extent can a group health plan share PHI with a plan sponsor with respect to Plan Administrative functions?

Answer:

A group health plan may disclose PHI to plan sponsors for plan admin functions such as quality assurance, claims processing or auditing Question 2: A health plan may condition payment of a specific claim on provision of an authorization to disclose PHI if such disclosure is necessary to determine payment.

Answer:

True Question 3: A special enrollment period is allowed for employees who declined coverage because they had other coverage which they subsequently lost.

Answer:

True

Question 4: The insurer of a group health plan may disclose health information on identifiable employees to a group health plan for purposes of obtaining premium bids

Answer:

False. An insurer can release summarized information about claims history, expenses, and types of claims. However, names and certain other identifying information must be removed.Question 5: HIPAA privacy standards address how the rights of individuals to determine health information is used or disclosed

Answer:

True Question 6: HIPAA allows a group health plan to provide more favorable terms to participants with adverse health conditions.

Answer:

True Question 7: . What is the rule imposed by HIPAA on a group health plan if the plan has both a waiting period and a preexisting-condition exclusion (PCE) period?

Answer:

The two periods must run concurrently.Question 8: Administrators of insured plans may delegate to insurers the obligation to issue certificates of creditable coverage?

Answer:

True

Question 9: What information is covered by Transaction Standards?

Answer:

Promote the standardization of certain payment-related electronic transactions Question 10: Coverage under HIPAA's special enrollment rights is effective on the date prior coverage ceases.

Answer:

False. Coverage under HIPAA's special enrollment rights begins on the first day of the month after the plan receives the enrollment form

Question 11: HIPAA permits pregnancy to be treated as a preexisting condition.

Answer:

False. HIPAA prohibits pregnancy from being treated as a preexisting condition.

Question 12: What Entities MUST comply with HIPAA?

Answer:

• The Group health plan itself (the sponsor)

• the Insurer of the Plan

Question 13: A special enrollment period is allowed for those who gain eligibility for a premium assistance subsidy under a state's Medicaid plan or CHIP.

Answer:

True Question 14: A preexisting-condition exclusion period otherwise allowed by HIPAA must be fully eliminated if a plan member has 6 months or more of prior creditable coverage? T/F

Answer:

False,Creditable coverage only reduces the exclusion period. For example, 8 months of creditable coverage would reduce a 12-month exclusion period to 4 months.Question 15: For purposes of HIPAA, the term health information includes premium payment information

Answer:

True Question 16: The HIPAA privacy standards require covered entities to train their workforces on privacy policies and procedures

Answer:

True Question 17: As long as specified conditions are satisfied, covered entities may disclose PHI without authorization for public policy purposes, such as judicial proceedings.

Answer:

True

Question 18: n order for a plan to impose a preexisting-condition exclusion, the plan must give written notice of the exclusion and terms, and an individual's right to demonstrate creditable coverage. T/F

Answer:

True Question 19: Which of the following statements concerning business associate contracts under HIPAA is (are) correct?

• They are unnecessary if the business associates are attorneys or accountants.

II. A covered entity is required to immediately terminate the contra

Answer:

I is incorrect because business associate contracts are necessary whenever a covered entity uses a business associate.II is incorrect because a covered entity must take steps to end the violation. Only if this is unsuccessful must the entity terminate t Question 20: Violation of HIPAA rules may result in both civil and criminal penalties. T/F

Answer:

True Question 21: HIPAA grants individuals the right to inspect and make a copy of their PH

Answer:

True Question 22: For purposes of HIPAA, protected health information (PHI) is defined as

Answer:

• individually identifiable health information that is maintained by a covered enti

Question 23: A covered entity that knows of a business associate's material violation of the business associate's contract must immediately terminate the contract.

Answer:

Feedback: False. The covered entity must take reasonable steps to end the violation. If that is unsuccessful, the covered entity must terminate the contract or, if not feasible, report the business associate to the federal Department of Health and Human S