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AHIP AHM-530 Exam Dumps - Actual Questions Answers

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AHM-530 Questions and Answers

Question # 1

The Portway Hospital is qualified to receive Medicaid subsidy payments as a disproportionate share hospital (DHS). The DHS payments that Portway receives are

A.

Made for services rendered to specific patients

B.

Made with matching state and federal funds

C.

Included in the Medicaid capitation payment made to patients’ health plans

D.

Defined as cost-based reimbursement (CBR) equal to 100% of Portway’s reasonable costs of providing services to Medicaid recipients

Question # 2

The two basic approaches that Medicaid uses to contract with health plans are open contracting and selective contracting. One true statement about these approaches to contracting is that:

A.

Open contracting requires health plans to meet minimum performance standards outlined in a state's request for proposal (RFP)

B.

Open contracting makes it possible for the Medicaid agency to offer enrollment volume guarantees

C.

Selective contracting requires any health plan that meets the state's performance standards and the federal Medicaid requirements to enter into a Medicaid contract

D.

Selective contracting requires health plans to bid competitively for Medicaid contracts

Question # 3

The Adobe Health Plan complies with all of the provisions of the Newborns' and Mothers' Health Protection Act (NMHPA) of 1996. Kristen Netzger, an Adobe enrollee, was hospitalized for a cesarean delivery. Amy Davis, also an Adobe enrollee, was hospitalized for a normal delivery. From the following answer choices, select the response that indicates the minimum length of time for which Adobe, under NMHPA, most likely must provide benefits for the hospitalizations of Ms. Netzger and Ms. Davis.

A.

Ms. Netzger = 48 hours

Ms. Davis = 48 hours

B.

Ms. Netzger = 72 hours

Ms. Davis = 72 hours

C.

Ms. Netzger = 96 hours

Ms. Davis = 48 hours

D.

Ms. Netzger = 96 hours

Ms. Davis = 72 hours

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