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AHIP Exam AHM-530 Topic 6 Question 101 Discussion

Actual exam question for AHIP's AHM-530 exam
Question #: 101
Topic #: 6
[All AHM-530 Questions]

The BBA of 1997 specifies the ways in which a Medicare+Choice plan can establish and use provider networks. A Medicare+Choice plan that operates as a private fee for service (PFFS) plan is allowed to

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Suggested Answer: A

by Bernadine at Sep 19, 2024, 07:59 AM

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Mitsue
13 days ago
Option B is the way to go, folks. Limiting provider payments to 115% of the Medicare rate - that's the key thing PFFS plans can do according to the BBA. Now excuse me while I go practice my 'haggling with providers' skills.
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Ira
18 days ago
Alright, let's see here. I'm going to have to go with option B. It just makes the most sense when it comes to PFFS plan requirements under the BBA of '97. Solid choice, if I do say so myself.
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Cletus
23 days ago
Haha, imagine if PFFS plans could just shift all the risk to the providers. That would be like playing 'hot potato' with Medicare-covered services! But I digress, I'd go with option B.
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Bettina
3 days ago
User 1: Haha, that would be quite the game of 'hot potato' with Medicare-covered services!
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Ronald
1 months ago
Hmm, this is a tricky one. I'm leaning towards option C, as PFFS plans can refuse payment to non-network providers. Gotta watch out for those sneaky non-network docs!
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Donette
18 days ago
Definitely, being aware of the rules around provider networks is crucial when choosing a Medicare+Choice plan.
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Colby
22 days ago
I agree, it's important to understand how PFFS plans handle payments to non-network providers.
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Lacey
23 days ago
I think you're onto something with option C. Non-network providers can be tricky.
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Ayesha
1 months ago
I'm not sure, but I think the answer might be C.
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Dan
1 months ago
I disagree, I believe the answer is A.
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Gennie
1 months ago
I think the answer is B.
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Simona
2 months ago
I see your point, but I still think A is the correct answer because it makes sense for the plan to limit the size of its network to meet the needs of its enrollees.
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Tamar
2 months ago
I think option B is the correct answer. The BBA of 1997 allows PFFS plans to limit the payment to providers to 115% of the Medicare rate.
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Merissa
1 days ago
Yes, it could be a challenge to find providers willing to accept the payment terms.
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Cordelia
8 days ago
But doesn't that also mean providers may be less willing to participate?
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Viva
22 days ago
That makes sense. It helps control costs for the plan.
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Glory
24 days ago
I agree, option B is correct. PFFS plans can limit payment to 115% of Medicare rate.
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Eura
2 months ago
I disagree, I believe the answer is B.
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Simona
2 months ago
I think the answer is A.
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