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AHM-510 Dumps With Exact Questions and Answers

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AHM-510 Questions and Answers

Question # 1

The Opal Health Plan complies with all of the provisions of the Newborns' and Mothers' Health Protection Act of 1996 (NMHPA). Samantha Hill and Debra Chao are Opal enrollees. Ms. Hill was hospitalized for a cesarean birth, and Ms. Chao was hospitalized for a normal delivery. From the following answer choices, select the response that indicates the minimum hospital stay for which Opal, under NMHPA, must provide benefits for Ms. Hill and Ms. Chao.

A.

Ms. Hill: 72 hours; Ms. Chao: 24 hours

B.

Ms. Hill: 72 hours; Ms. Chao: 48 hours

C.

Ms. Hill: 96 hours; Ms. Chao: 24 hours

D.

Ms. Hill: 96 hours; Ms. Chao: 48 hours

Question # 2

A federal law that significantly affects health plans is the Health Insurance Portability and Accountability Act of 1996 (HIPAA). In order to comply with HIPAA provisions, issuers offering group health coverage generally must.

A.

Renew group health policies in both small and large group markets, regardless of the health status of any group member

B.

Provide a plan member with a certificate of creditable coverage at the time the member enrolls in the group plan

C.

Both A and B

D.

A only

E.

B only

F.

Neither A nor B

Question # 3

The following statements describe various state benefit mandates. Select the answer choice that describes a state law pertaining to off-label uses for drugs.

A.

State A mandates that health plans provide benefits for experimental drugs for the treatment of terminal diseases such as AIDS and cancer.

B.

State B mandates that health plans have a procedure in place to allow a patient to have a non-formulary drug covered under certain conditions.

C.

State C mandates that, in dispensing generic drugs, pharmacies must label drug containers with the name of the substituted generic medication.

D.

State D mandates that health plans provide benefits for the treatment of one form of cancer with specific drugs that had originally been approved by the Food and Drug Administration (FDA) to treat other forms of cancer.

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