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Governance, Legal Issues, Medicare and Medicaid
Last Updated: Oct 3, 2024
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76 Questions and Answers for the AHIP AHM-510 exam
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AHIP Governance, Legal Issues, Medicare and Medicaid Syllabus
- Review relevant terms, industry issues, case scenarios and concepts/ Understand the legal issues surrounding ERISA, pharmacy benefits, and wellness
- Dig deep into the role of health insurance providers in providing services to both Medicare and Medicaid enrollees/ Examine legal issues faced by health insurance providers in a post-reform environment
- Learn the role of the federal government as a purchaser of health care benefits/ Explore factors shaping the health insurance industry, its formation, types of insurance, and structure
- Delve into federal and state regulatory requirements that affect health insurance providers/ Analyze how fraud and abuse affect health care’s cost and quality
- Explore how health insurance providers use organizational control systems to build internal structures that meet external demands for accountability
- Understand how health insurance providers use reorganization, reengineering, and strategic planning to improve performance