AHM-540 Free Practice Test

The paragraph below contains an incomplete statement. Select the answer choice containing the term that correctly completes the paragraph.
The Balanced Budget Act (BBA) of 1997 established the use of _______ to determine coverage of emergency services for Medicare and Medicaid enrollees in health plans.

1. A. utilization management standards
2. B. the prudent layperson standard
3. C. preauthorization
4. D. diagnosis-based retrospective review

Correct Answer: B

The Glenway Health Plan’s pharmacy and therapeutics (P&T) committee conducted pharmacoeconomic research to measure both the clinical outcomes and costs of two new cholesterol-reducing drugs. Results were presented as a ratio showing the cost required to produce a 1 mcg/l decrease in cholesterol levels. The type of pharmacoeconomic research that Glenway conducted in this situation was most likely

1. A. cost-effectiveness analysis (CEA)
2. B. cost-minimization analysis (CMA)
3. C. cost-utility analysis (CUA)
4. D. cost of illness analysis (COI)

Correct Answer: A

All states have laws describing the conditions under which pharmacists can substitute a generic drug for a brand-name drug. With respect to these laws, it is correct to say that in every state,

1. A. pharmacists must obtain physician approval before substituting generics for brand-name drugs
2. B. pharmacists must obtain authorization from the health plan before substituting generics for brand-name drugs
3. C. prescribers must obtain authorization from the health plan before prescribing a brand- name drug
4. D. prescribers have some mechanism that allows them to prevent pharmacists from substituting generics for brand-name drugs

Correct Answer: D

The Noble Health Plan conducted a cost/benefit analysis of the following four prescription drugs:
BenefitCost Drug A$525$350 Drug B$450$250
Drug C$400$200 Drug D$350$100
According to this analysis, the drug that represents the most efficient use of resources is

1. A. Drug A
2. B. Drug B
3. C. Drug C
4. D. Drug D

Correct Answer: D

Acute care refers to healthcare services for medical problems that

1. A. are expected to continue for a minimum of 30 days
2. B. are typically treated in a provider’s office or outpatient facility
3. C. require prompt, intensive treatment by healthcare providers
4. D. require low utilization of resources

Correct Answer: C