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AHM-510 Exam Dumps : Governance and Regulation

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Governance and Regulation Questions and Answers

Question 1

In the paragraph below, a statement contains two pairs of terms enclosed in parentheses.

Determine which term in each pair correctly completes the statement. Then select the answer choice containing the two terms that you have chosen.

Inflation plays a role in the health plan environment by influencing the prices of healthcare services, supplies, and coverage. During an inflationary period, consumers typically have (more / less) purchasing power because the prices of goods and services increase (more / less) quickly than income.

Options:

A.

More / more

B.

More / less

C.

Less / more

D.

Less / less

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Question 2

One federal law amended the Social Security Act to allow states to set their own qualification standards for HMOs that contracted with state Medicaid programs and revised the requirement that participating HMOs have an enrollment mix of no more than 50% combined Medicare and Medicaid members.

This act, which was the true stimulus for increasing participation by health plans in Medicaid, is called the

Options:

A.

Omnibus Budget Reconciliation Act of 1981 (OBRA-81)

B.

Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA)

C.

Employee Retirement Income Security Act of 1974 (ERISA)

D.

Federal Employees Health Benefits Act of 1958 (FEHB Act)

Question 3

Certificate of need (CON) laws apply to health plans in a variety of ways, depending upon the state. By definition, CON laws are laws that are designed to

Options:

A.

Regulate the construction, renovation, and acquisition of healthcare facilities as well as the purchase of major medical equipment in a geographical area

B.

Protect commerce from unlawful restraint of trade, price discrimination, price fixing, reduced competition, and monopolies

C.

Determine benefit payments when a person is covered by more than one plan, such as two group health plans

D.

License and regulate health plans that wish to establish and operate an HMO