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AHM-540 - Medical Management

AHIP AHM-540 Last Week Results!

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AHIP AHM-540

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AHIP AHM-540 Questions Answers

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AHM-540 Questions and Answers

Question # 1

The following statements are about QAPI as it applies to Medicare+Choice plans and Medicaid health plan entities. Select the answer choice containing the correct statement.

A.

QAPI provides separate sets of standards for Medicaid MCEs and Medicare+Choice plans.

B.

Medicaid primary care case management (PCCM) programs are required to comply with all QAPI standards.

C.

QISMC standards for quality measurement and improvement apply only to clinical services delivered to Medicare and Medicaid enrollees.

D.

States that require Medicaid MCEs to comply with QAPI standards are considered to be in compliance with CMS quality assessment and improvement regulations.

Question # 2

Readiness is an important consideration for the development of health promotion programs. Readiness refers to

A.

the availability of previously established health promotion programs to an health plan’s members through employers, providers, or community service agencies

B.

the appropriateness of a program’s educational approach, given the language, literacy level, and cultural sensitivities of the target population

C.

a member’s level of knowledge about existing health risks and problems and the member’s ability and willingness to adopt new health-related behaviors

D.

a member’s access to information technology, such as a video cassette recorder, a computer, or the Internet

Question # 3

Most health plans require a PCP referral or precertification for CAM benefits.

A.

True

B.

False

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