Answer: D. Reviewing the competency of health care workers.
Explanation: Healthcare operations are certain administrative, financial, legal, and quality improvement activities of a covered entity that are necessary to run its business and to support the core functions of treatment and payment. These activities, which are limited to the activities listed in the definition of “healthcare operations” at 45 CFR 164.501, include
1. Conducting quality assessment and improvement activities, population-based activities relating to improving healthcare or reducing costs, and case management and care coordination
2. Reviewing the competence or qualifications of healthcare professionals, evaluating provider and health plan performance, training healthcare and non-healthcare professionals, accreditation, certification, licensing, or credentialing activities
3. Underwriting and other activities relating to the creation, renewal, or replacement of a contract of health insurance or health benefits; and ceding, securing, or placing a contract for reinsurance of risk relating to healthcare claims
4. Conducting or arranging for medical review, legal services, and auditing functions, including fraud and abuse detection and compliance programs
5. Business planning and development, such as conducting cost-management and planning analyses related to managing and operating the entity
7. Business management and general administrative activities, including those related to implementing and complying with the Privacy Rule; customer service; grievance resolution; the sale, transfer, merger, or consolidation of all or part of the covered entity with another covered entity; and fundraising for the benefit of the covered entity...PF
