AHIP 2026: Understanding Discrimination, Fraud, Waste, and Abuse

AHIP 2026: Understanding Discrimination,
Fraud, Waste, and Abuse




Under ACA Section 1557, a health plan premium sold through a state exchange may, based on an individual's
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age and - correct answers charge higher premiums.
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As a result of violations of ACA Section 1557 nondiscrimination rules, - correct answers a health plan may
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revoke an agent or broker's appointment with the health plan.
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ACA Section 1557 rules for disability concern - correct answers policies and procedures, physical access, and
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communication.



Which Medicare programs are covered by ACA Section 1557 under the Biden Administration's Final Rule
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(2024)? - correct answers Parts A, C, and D, and Part B.
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Which of the following statements best describes Section 1557 of the Affordable Care Act (ACA)? - correct
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answers Section 1557 incorporates earlier civil rights protections in regard to race, color, national origin,
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disability, age and sex. E E E




Section 1557 of the Affordable Care Act applies to - correct answers all health programs and activities
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administered by or receiving federal financial assistance from HHS. E E E E E E E E




Which of the following would be considered permissible under Section 1557? - correct answers Broker Mary
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Jones has recruited a diverse workforce. She encourages her agents to prospect through community-based
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marketing and within their community of influence. E E E E E E

, Which of these actions is most likely to be permitted in dealing with a person with limited English proficiency? -
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correct answers Allowing a child to interpret in an emergency.
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Which of the following statements best describes the scope of operations subject to Section 1557 under the
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Final Rule (2024) of the Biden Administration? - correct answers Entities principally engaged in health care,
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which includes health insurers, must comply with Section 1557 for all programs they offer.
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For a health plan, what are the possible consequences of violations of ACA Section 1557? - correct answers
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Loss of federal business and compensatory damages.
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Auxiliary aids and services must be provided to individuals with disabilities, such as those suffering from vision
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or hearing impairments, free of charge, and in a timely manner. Auxiliary aids and services include which of
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the following: E




I. large print materials
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II. qualified sign language interpreters
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III. braille materials and displays
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IV. screen reader software - correct answers I, II, III, and IV
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Under ACA Section 1557, a health plan - correct answers cannot deny coverage to LEP individuals and is
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required to provide language assistance to them, free of charge. E E E E E E E E E




Under Section 1557, the 2020 Final Rule issued during the Trump Administration sex was initially
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defined____________ - correct answers as biologic sex only, meaning whether a person was determined to E E E E E E E E E E E E E E E




be male or female at birth.
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Which entity enforces Section 1557 for programs that receive funding from and are administered by HHS? -
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correct answers The Office of Civil Rights (OCR) of HHS.E E E E E E E E E




You are performing a regular inventory of the controlled substances in the pharmacy. You discover a minor
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inventory discrepancy. What should you do? - correct answers Follow your pharmacy's procedures.
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