AHIP

AHIP latest Final Exam Practice Questions 2023/2024

AHIP Final Exam ELABORATION LATEST UPDATE 2023|2024 GRADED A+ Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but when he looks at information on various plans available in his area, he sees a wide range in what they charge for deductibles, premiums and cost sharing. How can you explain this to him? Medicare Part D drug plans may have different benefit structures, but on average, they must all be at least as good as the standard model establi...

Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? Fraud Which of the following is not potentially a penalty for violation of the law or regulation prohibiting fraud, waste and abuse (fwa)? Deportation A person comes into your pharmacy to drop off a prescription for a beneficiary who is a regular customer. The prescription is for a controlled substance with a quantity of 160. This beneficiary normally receives a quantity of 60, not 16...

Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know which of the following services Original Medicare will cover if the appropriate criteria are met? What could you tell her? Original Medicare covers ambulance services. Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan. What should you tell him? Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part A...

Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know which of the following services Original Medicare will cover if the appropriate criteria are met? What could you tell her? Original Medicare covers ambulance services. Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan. What should you tell him? Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part A...

Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? Fraud Which of the following is NOT potentially a penalty for violation of a law or regulation prohibiting Fraud, Waste, and Abuse (FWA)? Deportation A person comes to your pharmacy to drop off a prescription for a beneficiary who is a "regular" customer. The prescription is for a controlled substance with a quantity of 160. This beneficiary normally receives a quantity of 60, not 1...

Compliance is the responsibility of the compliance officer, compliance committee and upper management only False Ways to report a compliance issue include All of the above What is the policy of non-retaliation Protects employees who, in good faith, report suspected non-compliance These are examples of issues that can be reported to a compliance department :suspected fraud, waste, and abuse; potential health privacy violation and unethical behavior/employee misconduct True Once a ...

ACA SECTION 1557 DIFFERS FROM EARLIER LEGISLATION IN PROVIDING BROADER PROTECTION AGAINST DISCRIMINATION BASED ON SEX SECTION 1557 OF THE AFFORDABLE CARE ACT APPLIES TO ALL HEALTH PROGRAMS AND ACTIVITES ADMINSTRATED BY OR RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM HHS. WHICH MEDICARE PROGRAMS ARE COVERED BY ACA SECTION 1557? PARTS A,C, AND D, BUT NOT B UNDER ACA SECTION 1557, PROHIBITED ACTION INVOLVE ELIGIBILITY, CLAIMS, AND MARKETING UNDER ACA SECTION 1557, A PERSON CANNOT BE...

Medicare plan means A MA plan, MA-PD plan or PDP Subcontractor means **An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizations with INDIRECT relationship, such as an agent who has a contract with an agency or filed marketing organization that contract with a Medicare plan. FWA Training: A compliance program component **ALL Medicare plan...

Mr. Garcia was told he qualifies for a Special Enrollment Period (SEP), but he lost the paper that explains what he could do during the SEP. What can you tell him? If the SEP is for MA coverage, he will generally have one opportunity to change his MA coverage. 3 MULTIPLE CHOICE OPTIONS Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover prescription drugs, ...