CHC Exam for Health Care Compliance Association (HCCA) Compliance Certification Board (CCB) Latest Update

CHC Exam for Health Care Compliance Association (HCCA) Compliance Certification Board (CCB) Latest Update

CHC Exam for Health Care Compliance Association (HCCA) Compliance Certification Board (CCB) Latest Update

The Certified in Healthcare Compliance (CHC) credential, awarded by the Health Care Compliance Association (HCCA) through the Compliance Certification Board (CCB), is one of the most respected certifications for professionals in the healthcare compliance field. This certification demonstrates a professional's comprehensive understanding of the laws, regulations, and standards that govern healthcare organizations. As healthcare systems and regulations continue to evolve, staying up-to-date with changes to the CHC exam and certification requirements is crucial for compliance professionals. This article will explore the latest updates and information about the CHC exam, including eligibility, exam content, study resources, and key developments for 2023 and beyond.

Understanding the CHC Exam

The CHC exam is designed to assess the knowledge and expertise required for individuals working in healthcare compliance. Whether working in a hospital, insurance company, pharmaceutical firm, or medical practice, compliance professionals play a vital role in ensuring that their organizations adhere to a complex web of federal and state regulations. The CHC certification validates the professional’s ability to manage, monitor, and oversee compliance with healthcare laws.

The exam covers a variety of topics essential to healthcare compliance, including regulatory frameworks, compliance program administration, risk management, and auditing. A certified individual demonstrates the ability to navigate these areas effectively, ensuring that healthcare organizations mitigate the risk of fraud, abuse, and non-compliance with laws.

Exam Content and Structure

As of 2023, the CHC exam content outline was updated to reflect the growing complexities of healthcare compliance. The exam structure is as follows:

1. Compliance Program Administration (20%): This section assesses the candidate's understanding of the fundamental components of a compliance program. Key topics include creating, implementing, and managing compliance programs, as well as understanding the structure and leadership of compliance initiatives. The administration of an effective compliance program also involves monitoring and auditing, policy and procedure development, and reporting mechanisms.

2. Risk Assessment and Monitoring (15%): Compliance professionals need to identify, assess, and mitigate risks that could impact healthcare organizations. This section tests the candidate’s knowledge of conducting risk assessments and using monitoring tools to detect and prevent violations. Risk management also involves creating strategies to address emerging risks, and professionals must know how to assess both financial and operational risks in healthcare.

3. Regulatory Framework and Governance (25%): A core part of healthcare compliance involves understanding the legal and regulatory framework in which healthcare organizations operate. This section focuses on healthcare laws such as the Health Insurance Portability and Accountability Act (HIPAA), the False Claims Act, the Anti-Kickback Statute, and the Stark Law, along with other federal, state, and industry-specific regulations. Knowledge of governance structures, ethical standards, and compliance reporting mechanisms also falls under this category.

4. Education and Training (15%): Compliance professionals are often responsible for creating and implementing educational programs for employees, management, and stakeholders. This section evaluates a candidate’s ability to develop and conduct training programs to raise awareness of compliance policies, regulatory requirements, and ethical standards. Education and training are essential tools for preventing violations and promoting a culture of compliance within healthcare organizations.

5. Investigations and Enforcement (15%): When non-compliance or fraud is suspected, healthcare organizations must conduct investigations and take corrective actions. This section tests the knowledge of compliance professionals regarding investigative procedures, conducting audits, and reporting violations to the appropriate authorities. Understanding how to handle enforcement actions and working with external regulators (such as the Department of Health and Human Services, or HHS) is also an important aspect of this section.

6. Auditing and Monitoring (10%): Auditing and monitoring are key activities for maintaining compliance within healthcare organizations. This section examines the candidate’s ability to design and implement effective auditing and monitoring systems to ensure that organizational activities remain in line with applicable laws and policies. It covers various audit techniques, including financial audits, operational audits, and clinical audits, along with ongoing monitoring processes.

The CHC exam consists of 125 multiple-choice questions, and candidates have three hours to complete the exam. The passing score is set at approximately 70%, meaning candidates must answer at least 88 of the questions correctly.

Eligibility and Requirements

To be eligible to sit for the CHC exam, candidates must meet certain work experience requirements. These requirements typically include:

• Two years of work experience in healthcare compliance, legal, regulatory affairs, or a related field. This experience may be gained in various roles, including compliance officer, auditor, legal advisor, and policy advisor within healthcare organizations.
• Alternatively, candidates can substitute a combination of education and experience. A bachelor’s degree in a related field, such as healthcare administration, law, or business, may count toward meeting eligibility criteria.

Candidates must submit an application through the CCB’s online portal and pay the appropriate examination fee. It is important to verify that all eligibility criteria are met before applying, as failing to do so may lead to disqualification.

Preparation and Study Resources

Preparing for the CHC exam is a significant undertaking, and candidates are encouraged to use a variety of resources to ensure success. The HCCA provides several study materials, including:

• Study Guides: The HCCA offers a comprehensive study guide that provides an overview of the exam content, along with sample questions and answers. This is an excellent starting point for understanding the key areas of the exam.
• Webinars and Review Courses: For in-depth review, candidates can participate in HCCA webinars and review courses. These resources are especially useful for those who prefer structured study sessions and direct interaction with experts in healthcare compliance.
• Practice Exams: Practice exams provide a simulated testing environment, helping candidates familiarize themselves with the exam format and question types. This is an essential tool for time management and understanding how the exam will challenge them.

There are also numerous online forums and study groups available for candidates to share resources, discuss difficult topics, and exchange study tips.

Maintaining Certification

Once you earn the CHC certification, it’s essential to maintain it by completing continuing education units (CEUs). The CCB requires certified professionals to earn 20 CEUs every two years. Of these, at least 10 CEUs must be healthcare-compliance-specific, covering topics such as HIPAA, healthcare regulations, risk management, and audits. CEUs can be earned through various educational activities, including conferences, seminars, workshops, and webinars.

Latest Trends and Updates in Healthcare Compliance

The landscape of healthcare compliance is continuously evolving, with new regulations, technologies, and industry standards emerging regularly. Some of the latest trends in healthcare compliance that professionals should be aware of include:

• Telehealth Compliance: As telehealth has become more prevalent, ensuring compliance with healthcare laws related to remote patient care is critical.
• Data Privacy and Security: With increasing concerns over healthcare data breaches, compliance professionals must stay abreast of privacy regulations such as HIPAA and the General Data Protection Regulation (GDPR).
• Fraud Prevention: The ongoing fight against healthcare fraud and abuse remains a primary focus for compliance officers, with emphasis on preventing billing fraud, kickbacks, and false claims.

Conclusion

The CHC certification is a valuable credential for healthcare compliance professionals, ensuring they possess the necessary knowledge and skills to navigate the complex regulatory landscape of the healthcare industry. As the healthcare environment continues to change, staying current with the latest exam updates, study resources, and regulatory trends is essential for ongoing success. By preparing effectively and understanding the core components of the CHC exam, professionals can not only earn their certification but also position themselves as leaders in healthcare compliance, ultimately helping their organizations thrive in an increasingly regulated environment.

For the most current updates and resources, candidates should regularly check the official websites of the Health Care Compliance Association (HCCA) and the Compliance Certification Board (CCB).