AHM-250 Free Practice Test

- (Topic 3)
The following statements are about federal laws that affect healthcare organizations. Select the answer choice containing the correct response.

1. A. The Women's Health and Cancer Rights Act (WHCRA) of 1998 requires health plans to offer mastectomy benefits.
2. B. The Health Care Quality Improvement Act (HCQIA) requires hospitals, group practices, and HMOs to comply with all standard antitrust legislation, even if these entities adhere to due process standards that are outlined in HCQIA.
3. C. The Newborns' and Mothers' Health Protection Act (NMHPA) of 1996 mandates that coverage for hospital stays for childbirth must generally be a minimum of 24 hours for normal deliveries and 48 hours for cesarean births.
4. D. Although the Mental Health Parity Act (MHPA) does not require health plans to offer mental health coverage, it imposes requirements on those plans that do offer mental health benefits.

Correct Answer: D

- (Topic 2)
One feature of the Employee Retirement Income Security Act (ERISA) is that it:

1. A. Requires self-funded employee benefit plans to pay premium taxes at the state level.
2. B. Contains a pre-emption provision, which typically makes the terms of ERISA take precedence over any state laws that regulate employee welfare benefit plans.
3. C. Contains strict reporting and disclosure requirements for all employee benefit plans except health plans.
4. D. Requires that state insurance laws apply to all employee benefit plans except insured plans.

Correct Answer: B

- (Topic 3)
The health plan determines what it considers to be the acceptable fee for a service or procedure and the physician agrees to accept that amount as payment in full for the procedure

1. A. Usual, Customary, and Reasonable fee
2. B. Discounted FFS
3. C. Fee Maximum
4. D. Relative Value Scale

Correct Answer: B

- (Topic 1)
Health plans can organize under a not-for-profit form or a for-profit form. One true statement regarding not-for-profit health plans is that these organizations typically

1. A. are exempt from review by the Internal Revenue Service (IRS)
2. B. are organized as stock companies for greater flexibility in raising capital
3. C. rely on income from operations for the large cash outlays needed to fund long-term projects and expansion
4. D. engage in lobbying or political activities in order to maintain their tax-exempt status

Correct Answer: C

- (Topic 2)
Most contracts between health plans and providers contain a provision which forbids providers from seeking compensation from patients if the health plan fails to compensate the provider because of insolvency or for any other reason. Such a provision is kn

1. A. due process provision
2. B. cure provision
3. C. hold-harmless provision
4. D. risk-sharing provision

Correct Answer: C