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AHM-510 Exam Dumps : Governance and Regulation

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Governance and Regulation Questions and Answers

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Question 1

TRICARE, a military healthcare program, offers eligible beneficiaries three options for healthcare services: TRICARE Prime, TRICARE Extra, and TRICARE Standard. With respect to plan features, both an annual deductible and claims filing requirements must be met, regardless of whether care is delivered by network providers, under

Options:

A.

TRICARE Prime and TRICARE Extra only

B.

TRICARE Extra and TRICARE Standard only

C.

TRICARE Standard only

D.

None of these healthcare options

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Question 2

While traditional workers' compensation laws have restricted the use of managed care techniques, many states now allow managed workers' compensation. One common characteristic of managed workers' compensation plans is that they

Options:

A.

Discourage injured employees from returning to work until they are able to assume all the duties of their jobs

B.

Use low copayments to encourage employees to choose preferred providers

C.

Cover an employee's medical costs, but they do not provide coverage for lost wages

D.

Rely on total disability management to control indemnity benefits

Question 3

The Wentworth Corporation uses a self-funded plan to provide its employees with healthcare benefits. One consequence of Wentworth's approach to providing healthcare benefits is that self-funding

Options:

A.

Requires that Wentworth self-administer its healthcare benefit plan

B.

Requires that Wentworth pay higher state premium taxes than do insurers and health plans

C.

Eliminates the need for Wentworth to pay a risk charge to an insurer or health plan

D.

Increases the number of benefit and rating mandates that apply to Wentworth's plan

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