AHIP AHM-250 問題集

質問 1：
From the following answer choices, choose the description of the ethical principle that best corresponds to the term Beneficence
A. Health plans and their providers are obligated not to harm their members
B. Health plans and their providers should treat each member in a manner that respects the member's goals and values, and they also have a duty to promote the good of the members as a group
C. Health plans and their providers should allocate resources in a way that fairly distributes benefits and burdens among the members
D. Health plans and their providers have a duty to respect the right of their members to make decisions about the course of their lives
正解：B

質問 2：
As part of its utilization management (UM) system, the Poplar MCO uses a process known as case management. The following statements describe individuals who are Poplar plan members:
- Brad Van Note, age 28, is taking many different, costly medications for
A. Mr. Van Note, Mr. Albrecht, and Ms. Cromartie
B. Mr. Van Note and Ms. Cromartie only
C. Mr. Van Note and Mr. Albrecht only
D. Mr. Albrecht and Ms. Cromartie only
正解：C

質問 3：
When the Knoll Company purchased group health coverage from the Castle Health Maintenance Organization (HMO), the agreement between the two parties specified that the plan would be a typical fully funded plan. Because Knoll had been covered under a previo
A. Knoll makes no premium payments to Castle
B. Knoll is solely responsible for guaranteeing claim payments
C. Castle is responsible for paying for all incurred covered benefits
D. Castle has no responsibilities for administering the health plan
正解：C

質問 4：
One true statement regarding ethics and laws is that the values of a community are reflected in
A. ethics only, but only laws are enforceable in the court system
B. both ethics and laws, and both ethics and laws are enforceable in the court system
C. laws only, but both ethics and laws are enforceable in the court system
D. both ethics and laws, but only laws are enforceable in the court system
正解：D

質問 5：
Before an HMO contracts with a physician, the HMO first verifies the physician's credentials.
Upon becoming part of the HMO's organized system of healthcare, the physician is typically subject to
A. peer review only
B. neither recredentialing nor peer review
C. both recredentialing and peer review
D. recredentialing only
正解：A

質問 6：
The following statements apply to flexible spending arrangements. Select the answer
choice that contains the correct statement.
A. FSAs were designed to help increase health insurance coverage among self-employed individuals.
B. A popular feature of FSAs is their portability, which allows employees to take the funds with them when they change jobs.
C. Only employers may contribute funds to FSAs.
D. The popularity of FSAs has been limited because funds may not be rolled over from year to year.
正解：D

質問 7：
The existing committees at the Majestic Health Plan, a health plan that is subject to the requirements of HIPAA, include the Executive Committee and the Corporate Compliance Committee. The Executive Committee serves as a long-term advisory body on issues
A. Neither 1 nor 2
B. 2 only
C. Both 1 and 2
D. 1 only
正解：D