AHM-250 Free Practice Test

- (Topic 3)
Medigap policies were standardized into ten standard benefit pl ranging from A-J by the

1. A. Omnibus Budget Reconciliation Act (OBRA) of 1990
2. B. Tax Equity & Fiscal Responsibility Act (TEFRA) of 1982
3. C. Medicare Modernization Act (MMA) of 2003
4. D. Balanced Budget Act (BBA) of 1997

Correct Answer: A

- (Topic 3)
The Granite Health Plan is a coordinated care plan (CCP) that participates in the Medicare+Choice program. This information indicates that Granite

1. A. must comply with all state-mandated benefits and provider requirements
2. B. must offer each of its enrollees a Medicare supplement
3. C. places primary care t the censer of the delivery system and focuses on managing patient care at all levels
4. D. most likely must cover Medicare Part A, but not Medicare Part B, benefits

Correct Answer: C

- (Topic 3)
Which of the following statements about EPO & HMO models is FALSE?

1. A. In-network visit is allowed only on PCP's referral in HMO model.
2. B. Out-of-network visit is not allowed in HMO model.
3. C. Out-of-network visit is not allowed in EPO model.
4. D. In-network visit is allowed only on PCP's referral in EPO model.

Correct Answer: A

- (Topic 2)
Mr. George Bush is covered by a PBM plan that uses a closed formulary. This indicates that

1. A. he can receive coverage for pharmaceuticals only if they are on the PBM plan's preferred list of drugs
2. B. he must receive all of his pharmaceuticals from a mail-order pharmacy program
3. C. he can receive coverage for pharmaceuticals that are on the PBM plan's preferred list of drugs, as well as for pharmaceuticals that are not on the preferred list
4. D. the PBM plan cannot receive a rebate on any pharmaceuticals it obtains from the pharmaceutical facture

Correct Answer: A

- (Topic 1)
Following a report by the Institute of Medicine on the incidence and consequences of medical errors, a national task force recommended implementation of a nationwide mandatory system of collecting, analyzing, and reporting standardized information about m

1. A. random change
2. B. structural change
3. C. haphazard change
4. D. reactive change

Correct Answer: D