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Free AHM-530 Exam Braindumps (page: 4)

Page 3 of 51
PDF with 202 Questions

After HIPAA was enacted, Congress amended the law to include the Mental Health Parity Act (MHPA) of 1996, a federal requirement relating to mental health benefits. One true statement about the MHPA is that it

  1. requires all health plans to provide coverage for mental health services
  2. requires health plans to carve out mental/behavioral healthcare from other services provided by the plans
  3. allows health plans to require patients receiving mental health services to pay higher copayments than patients seeking treatment for physical illnesses
  4. prohibits health plans that offer mental health benefits from applying more restrictive limits on coverage for mental illness than on coverage for physical illness

Answer(s): D



From the following answer choices, choose the term that best matches the description.

An integrated delivery system (IDS), which controls most providers in a particular specialty, agrees to provide that specialty service to a health plan only on the condition that the health plan agree to contract with the IDS for other services.

  1. Group boycott
  2. Horizontal division of territories
  3. Tying arrangements
  4. Concerted refusal to admit

Answer(s): C



From the following answer choices, choose the term that best matches the description.

Members of a physician-hospital organization (PHO) denied membership to a physician solely because the physician has admitting privileges at a competing hospital.

  1. Group boycott
  2. Horizontal division of territories
  3. Tying arrangements
  4. Concerted refusal to admit

Answer(s): A



Some states have enacted any willing provider laws. From the perspective of the health plan industry, one drawback of any willing provider laws is that they often result in a reduction of a plan's

  1. Premium rates
  2. Ability to monitor utilization
  3. Number of primary care providers (PCPs)
  4. Number of specialists and ancillary providers

Answer(s): B






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