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 AHM-510 Dumps with Practice Exam Questions Answers

Questions: 76 questions

Last Update: Sep 22, 2023

AHIP Certification Exam AHM-510 has been designed to measure your skills in handling the technical tasks mentioned in the certification syllabus

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AHM-510 Questions and Answers

Question # 1

Any willing provider laws have their share of proponents and opponents. Arguments commonly made in opposition to any willing provider laws include


That such laws reduce the number of providers in a health plan's network


That such laws limit consumer choice to coverage options that are more costly than network-based plans


That such laws encourage providers to offer discounts in exchange for patient volume


All of the above

Question # 2

The Sawgrass Health Center is an institution that trains healthcare professionals and performs various clinical and other types of healthcare-related research. Because Sawgrass receives government funding, it is required to provide medical care for the poor. Of the following types of health plans, Sawgrass can best be described as:


A medical foundation


An academic medical center (AMC)


A healthcare cooperative


A community health center (CHC)

Question # 3

Determine whether the following statement is true or false:

Although most-favored-nation (MFN) clauses in contracts between health plans and healthcare providers are not per se illegal, they should be reviewed under the rule of reason analysis for antitrust purposes.


True, because the Federal Trade Commission (FTC) ruled that MFN clauses are not per se illegal and the FTC encourages health plans to include them in provider contracts.


True, because although MFN clauses are not per se illegal, they violate antitrust laws if they have a predatory purpose and an anticompetitive effect.


False, because MFN clauses involve decisions by providers concerning the level of fees to charge, and thus they are per se illegal.


False, because MFN clauses are not per se illegal, and thus they are exempt from antitrust laws and regulation by the FTC.

Question # 4

The following situations illustrate per se violations of federal antitrust laws:

Situation A - Two groups of providers agreed among themselves that each provider will do business with health plans only on a fee-for-service basis.

Situation B - In order to avoid competing with each other, two independent, competing physician-hospital organizations (PHOs) divide the geographic areas in which they will market their services.

From the following answer choices, select the response that correctly identifies the types of per se violations illustrated by these situations.


Situation A: price fixing; Situation B: horizontal division of markets


Situation A: price fixing; Situation B: tying arrangement


Situation A: horizontal group boycott; Situation B: horizontal division of markets


Situation A: horizontal group boycott; Situation B: tying arrangement

Question # 5

The Tidewater Life and Health Insurance Company is owned by its policy owners, who are entitled to certain rights as owners of the company, and it issues both participating and nonparticipating insurance policies. Tidewater is considering converting to the type of company that is owned by individuals who purchase shares of the company's stock. Tidewater is incorporated under the laws of Illinois, but it conducts business in the Canadian provinces of Ontario and Manitoba.

Tidewater established the Diversified Corporation, which then acquired various subsidiary firms that produce unrelated products and services. Tidewater remains an independent corporation and continues to own Diversified and the subsidiaries. In order to create and maintain a common vision and goals among the subsidiaries, the management of Diversified makes decisions about strategic planning and budgeting for each of the businesses.

In order to become the type of company that is owned by people who purchase shares of the company's stock, Tidewater must undergo a process known as


management buy-out


piercing the corporate veil