AHIP Exam AHM-530 Topic 2 Question 77 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 77
Topic #: 2

As an authorized Medicare+Choice plan, the Brightwell HMO must satisfy CMS requirements regulating access to covered services. In order to ensure that its network provides adequate access, Brightwell must

AAllow enrollees to determine whether they will receive primary care from a physician, nurse practitioner, or other qualified network provider

BBase a provider's participation in the network, reimbursement, and indemnification levels on the provider's license or certification

CDefine its service area according to community patterns of care

DRequire enrollees to obtain prior authorization for all emergency or urgently needed services

Show Suggested Answer

Suggested Answer: A

by Cecilia at Nov 22, 2023, 04:33 PM

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Ciara

2 days ago

I'm not sure about Option B. Basing provider participation on their license or certification doesn't necessarily guarantee adequate access, does it?

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Charolette

4 days ago

Option C seems like the most logical choice. Defining the service area according to community patterns of care ensures that the network is accessible to the target population.

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Antonette

5 days ago

I think the answer is C.

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