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AHIP AHM-530 Exam With Confidence Using Practice Dumps

Exam Code:
AHM-530
Exam Name:
Network Management
Certification:
Vendor:
Questions:
202
Last Updated:
Feb 26, 2026
Exam Status:
Stable
AHIP AHM-530

AHM-530: AHIP Certification Exam 2025 Study Guide Pdf and Test Engine

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Network Management Questions and Answers

Question 1

The following statement(s) can correctly be made about the Balanced Budget Act (BBA) of 1997:

Options:

A.

The BBA requires Medicare+Choice organizations to be licensed as non-risk-bearing entities under federal law.

B.

The Centers for Medicaid and Medicare Services (CMS) is responsible for implementing the BBA.

C.

Both A and B

D.

A only

E.

B only

F.

Neither A nor B

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Question 2

Dr. Sylvia Cimer and Dr. Andrew Donne are obstetrician/gynecologists who participate in the same provider network. Dr. Comer treats a large number of high-risk patients, whereas Dr. Donne’s patients are generally healthy and rarely present complications. As a result, Dr. Comer typically uses medical resources at a much higher rate than does Dr. Donne. In order to equitably compare Dr. Comer’s performance with Dr. Donne’s performance, the health plan modified its evaluation to account for differences in the providers’ patient populations and treatment protocols. The health plan modified Dr. Comer’s and Dr. Donne’s performance data by means of

Options:

A.

Acase mix/severity adjustment

B.

An external performance standard

C.

Structural measures

D.

Behavior modification

Question 3

The following statements are about Medicaid health plan entities. Select the answer choice containing the correct statement:

Options:

A.

To keep Medicaid enrollment costs as low as possible, states typically prohibit the use of third-party entities known as enrollment brokers to handle the recruitment and enrollment of Medicaid recipients in health plan plans

B.

Primary care case managers (PCCMs) are individuals who contract with a state's Medicaid agency to provide primary care services mainly to urban areas.

C.

Typically, Medicaid beneficiaries must be given a choice between at least two health plan entities.

D.

Medicaid health plan entities are responsible for providing primary coverage for all dually-eligible beneficiaries.