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AHM-510 Exam

Governance and Regulation

  • Exam Number/Code : AHM-510
  • Exam Name : Governance and Regulation
  • Questions and Answers : 76 Q&As
  • Update Time: 2017-11-13
  • Price: $ 99.00 $ 39.00

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Exam Description or Exam Demo

Exam code : AHM-510

Exam name : Governance and Regulation


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.

One type of acquisition is called a stock purchase. In a typical stock purchase, a company

acquires (51% / 100%) of the voting shares of another company's stock, thereby making

the acquired company a subsidiary. The (acquired / acquiring) company holds all of the

assets and liabilities of the acquired company.

A. 51% / acquired

B. 51% / acquiring

C. 100% / acquired

D. 100% / acquiring

Answer: C


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

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)

Answer: A


Question 3

The Surrey Medical Supply Company was formed as a limited partnership. In this

partnership, Victoria Lewin is one of the limited partners and Oscar Gould is a general

partner. This information indicates that, with respect to the typical characteristics of limited

partnerships,

A. Ms. Lewin has more freedom to opt out of the partnership than does Mr. Gould

B. Ms. Lewin has more liability for the debts of Surrey than does Mr. Gould

C. both Ms. Lewin and Mr. Gould participate in the day-to-day management of Surrey

D. the partnership will continue upon the death of Mr. Gould, whereas it will end with the

death of Ms. Lewin

Answer: A


Question 4

The Tidewater Life and Health Insurance Company is owned by its policy owners, who are

entitled to certain rights as owners of the company, and it issues both participating and

nonparticipating insurance policies. Tidewater is considering converting to the type of

company that is owned by individuals who purchase shares of the company's stock.

Tidewater is incorporated under the laws of Illinois, but it conducts business in the

Canadian provinces of Ontario and Manitoba.

Tidewater established the Diversified Corporation, which then acquired various subsidiary

firms that produce unrelated products and services. Tidewater remains an independent

corporation and continues to own Diversified and the subsidiaries. In order to create and

maintain a common vision and goals among the subsidiaries, the management of

Diversified makes decisions about strategic planning and budgeting for each of the

businesses.

By combining under Diversified a group of businesses that produce unrelated products and

by consolidating the management of the businesses, Tidewater has achieved the type(s) of

integration known as

A. Conglomerate integration and operational integration

B. Horizontal integration and operational integration

C. Horizontal integration and virtual integration

D. Conglomerate integration only

Answer: A


Question 5

One example of health plan's influence on the practice of medicine is that, during the past

decade, the focus of healthcare has moved toward _________________, which is

designed to reduce the overall need for healthcare services by providing patients with

decision-making information.

A. Demand management

B. Managed competition

C. Comprehensive coverage

D. Private inurement

Answer: A


Question 6

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.

Every employee benefit plan governed by the Employee Retirement Income Security Act

(ERISA) must distribute a summary plan description (SPD) to participants within (90 / 120)

days after the date on which the plan is adopted or made effective. Thereafter, if the plan is

amended, a new SPD must be distributed every (5 / 10) years.

A. 90 / 5

B. 90 / 10

C. 120 / 5

D. 120 / 10

Answer: C


Question 7

Arthur Dace, a plan member of the Bloom Health Plan, tried repeatedly over an extended

period to schedule an appointment with Dr. Pyle, his primary care physician (PCP). Mr.

Dace informally surveyed other Bloom plan members and found that many people were

experiencing similar problems getting an appointment with this particular provider. Mr.

Dace threatened to take legal action against Bloom, alleging that the health plan had

deliberately allowed a large number of patients to select Dr. Pyle as their PCP, thus making

it difficult for patients to make appointments with Dr. Pyle.

Bloom recommended, and Mr. Dace agreed to use, an alternative dispute resolution (ADR)

method that is quicker and less expensive than litigation. Under this ADR method, both

Bloom and Mr. Dace presented their evidence to a panel of medical and legal experts, who

issued a decision that Bloom's utilization management practices in this case did not

constitute a form of abuse. The panel's decision is legally binding on both parties.

This information indicates that Bloom resolved its dispute with Mr. Dace by using an ADR

method known as:

A. Corporate risk management

B. An ombudsman program

C. An ethics committee

D. Arbitration

Answer: D


Question 8

After conducting a business portfolio analysis, the Acorn Health Plan decided to pursue a

harvest strategy with one of its strategic business units (SBUs)-Guest Behavioral

Healthcare. By following a harvest strategy with Guest, Acorn most likely is seeking to

A. Maximize Guest's short-term earnings and cash flow

B. Increase Guest's market share

C. Maintain Guest's market position

D. Sacrifice immediate earnings in order to fund Guest's growth

Answer: A


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