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AHM-530 Engine Package

AHM-530 Testing Engine (Downloadable)
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AHM-530 PDF Package

AHM-530 PDF Exam (Downloadable)
Latest 2024 Syllabus Topics Included
Updated : 24-Apr-2024
QA : 202
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AHIP AHM-530 Exam Dumps - Valid Questions Answers

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AHM-530 Questions and Answers

Question # 1

Federal laws—including the Ethics in Patient Referrals Act, the Health Maintenance Organization (HMO) Act of 1973, the Employee Retirement Income Security Act (ERISA), and the Federal Trade Commission Act—have impacted the ways that health plans conduct business. For instance, the Mosaic Health Plan must comply with the following federal laws in order to operate:

Regulation 1: Mosaic must establish a mandated grievance resolution mechanism, including a method for members to address grievances with network providers.

Regulation 2: Mosaic must not allow its providers to refer Medicare and Medicaid patients to entities in which they have a financial or ownership interest.

From the answer choices below, select the response that correctly identifies the federal legislation on which Regulation 1 and Regulation 2 are based.


Regulation 1 - The Ethics in Patient Referrals Act Regulation 2 - The HMO Act of 1973


Regulation 1 - The HMO Act of 1973 Regulation 2 - The Ethics in Patient Referrals Act


Regulation 1 - ERISA Regulation 2 - The Federal Trade Commission Act


Regulation 1 - The Federal Trade Commission Act Regulation 2 - ERISA

Question # 2

Some states have enacted any willing provider laws. From the perspective of the health plan industry, one drawback of any willing provider laws is that they often result in a reduction of a plan’s


Premium rates


Ability to monitor utilization


Number of primary care providers (PCPs)


Number of specialists and ancillary providers

Question # 3

Some jurisdictions have enacted corporate practice of medicine laws. One effect that corporate practice of medicine laws have had on HMO provider networks is that these laws typically


require incorporated HMOs to practice medicine through licensed employees


require HMOs to form exclusive contracts with physician groups who agree to dedicate all or most of their practices to HMO patients in return for a set payment or revenue-sharing


restrict the ability of staff model HMOs to hire physicians directly, unless the physicians own the HMO


encourage incorporated HMOs to obtain profits from their provisions of physician professional services

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