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AHIP Module 4 Exam Prep 2026 |
Medicare Compliance, Fraud, Waste &
Abuse (FWA) | Brand New Updated
Version | Expert-Reviewed Questions &
Answers | U.S. Program Aligned |
Guaranteed Success
You have approached a hospital administrator about marketing in her
facility. The administrator is uncomfortable with the suggestion. How
could you address her concerns?
---CORRECT -ANSWER☑️☑️☑️ Tell her that Medicare guidelines
allow you to conduct marketing activities in common areas of a
provider's facility.
Alice is a marketing representative employed by a health plan. Betty is a
captive agent of a health plan who markets for multiple plans and
sponsors. Carl is a captive agent who markets for only one plan/sponsor.
Denise is an independent agent who markets to different types of groups.
Edward is an independent agent who markets only to employer and
union groups. CMS marketing representative compensation rules
generally apply to:
---CORRECT -ANSWER☑️☑️☑️ Betty and Denise, but not Alice (the
employee) or Carl or Edward (to whom exceptions apply).
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Stephanie King becomes eligible for Medicare for the first time in July.
With the help of Agent James Chan, she enrolls in FeelBetter Medicare
Advantage plan with an effective date of July 1st. Which statement best
describes how Agent Chan may be compensated under CMS rules?
---CORRECT -ANSWER☑️☑️☑️ FeelBetter will pay Agent Chan
initial year compensation for July through December. The renewal
amounts will be paid starting in January if Ms. King remains enrolled
the following year.
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use
its enrollees' information to market non-health related products such as
life insurance and annuities. Which statement best describes ABC's
obligation to its enrollees regarding marketing such products?
---CORRECT -ANSWER☑️☑️☑️ It must obtain a HIPAA compliant
authorization from an enrollee that indicates the plan or plan sponsor
may use their information for marketing purposes.
Mrs. Lewis is turning 65 in November and called to ask for your help
deciding on a Medicare Advantage plan. She agreed to sign a scope of
appointment form and meet with you on October 15. During the
appointment, what are you permitted to do?
---CORRECT -ANSWER☑️☑️☑️ You may provide her with the
required enrollment materials and take her completed enrollment
application.
Mr. Lynn, an agent for Acme Insurance, Inc. thinks that, since state laws
are preempted concerning the marketing of Medicare health plans, he
AHIP Module 4 Exam Prep 2026 |
Medicare Compliance, Fraud, Waste &
Abuse (FWA) | Brand New Updated
Version | Expert-Reviewed Questions &
Answers | U.S. Program Aligned |
Guaranteed Success
You have approached a hospital administrator about marketing in her
facility. The administrator is uncomfortable with the suggestion. How
could you address her concerns?
---CORRECT -ANSWER☑️☑️☑️ Tell her that Medicare guidelines
allow you to conduct marketing activities in common areas of a
provider's facility.
Alice is a marketing representative employed by a health plan. Betty is a
captive agent of a health plan who markets for multiple plans and
sponsors. Carl is a captive agent who markets for only one plan/sponsor.
Denise is an independent agent who markets to different types of groups.
Edward is an independent agent who markets only to employer and
union groups. CMS marketing representative compensation rules
generally apply to:
---CORRECT -ANSWER☑️☑️☑️ Betty and Denise, but not Alice (the
employee) or Carl or Edward (to whom exceptions apply).
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Stephanie King becomes eligible for Medicare for the first time in July.
With the help of Agent James Chan, she enrolls in FeelBetter Medicare
Advantage plan with an effective date of July 1st. Which statement best
describes how Agent Chan may be compensated under CMS rules?
---CORRECT -ANSWER☑️☑️☑️ FeelBetter will pay Agent Chan
initial year compensation for July through December. The renewal
amounts will be paid starting in January if Ms. King remains enrolled
the following year.
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use
its enrollees' information to market non-health related products such as
life insurance and annuities. Which statement best describes ABC's
obligation to its enrollees regarding marketing such products?
---CORRECT -ANSWER☑️☑️☑️ It must obtain a HIPAA compliant
authorization from an enrollee that indicates the plan or plan sponsor
may use their information for marketing purposes.
Mrs. Lewis is turning 65 in November and called to ask for your help
deciding on a Medicare Advantage plan. She agreed to sign a scope of
appointment form and meet with you on October 15. During the
appointment, what are you permitted to do?
---CORRECT -ANSWER☑️☑️☑️ You may provide her with the
required enrollment materials and take her completed enrollment
application.
Mr. Lynn, an agent for Acme Insurance, Inc. thinks that, since state laws
are preempted concerning the marketing of Medicare health plans, he
