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AHM-510 Exam Dumps : Governance and Regulation

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Governance and Regulation Questions and Answers

Question 1

SoundCare Health Services, a health plan, recently conducted a situation analysis. One step in this analysis required SoundCare to examine its current activities, its strengths and weaknesses, and its ability to respond to potential threats and opportunities in the environment. This activity provided SoundCare with a realistic appraisal of its capabilities. One weakness that SoundCare identified during this process was that it lacked an effective program for preventing and detecting violations of law. SoundCare decided to remedy this weakness by using the 1991 Federal Sentencing Guidelines for Organizations as a model for its compliance program.

By definition, the activity that SoundCare conducted when it examined its strengths, weaknesses, and capabilities is known as

Options:

A.

An environmental analysis

B.

An internal assessment

C.

An environmental forecast

D.

A community analysis

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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

In examining accountability in the current managed care environment, one is likely to find that combinations of various models of accountability are in operation. Under one model of accountability, the primary mechanisms for accountability are the mechanisms of the marketplace-failure to meet standards will result in a loss of demand for services. By definition, this model of accountability is called the

Options:

A.

Professional model of accountability

B.

Political model of accountability

C.

Due diligence model of accountability

D.

Economic model of accountability