AHIP Exam AHM-530 Topic 6 Question 86 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 86
Topic #: 6

Following statements are about accreditation of health plans:

AThe National Committee for Quality Assurance (NCQA) serves as the primary accrediting agency for most health maintenance organizations (HMOs).

BThe Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has developed standards that can be used for the accreditation of hospitals, but not for the accreditation of health plan provider networks or health plan plans.

CStates are required to adopt the model standards developed by the National Association of Insurance Commissioners (NAIC), an organization of state insurance regulators that develops standards to promote uniformity in insurance regulations.

DAccreditation is an evaluative process in which a health plan undergoes an examination of its operating procedures to determine whether the procedures meet designated criteria as defined by the federal government or by the state governments.

Show Suggested Answer

Suggested Answer: D

by Tyra at Apr 28, 2024, 12:32 AM

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Dannie

4 days ago

I believe D is also important because accreditation ensures that health plans meet specific criteria.

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Tijuana

5 days ago

I agree with you, Ulysses. NCQA is definitely a major accrediting agency for HMOs.

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Julio

8 days ago

I think A and D are the correct statements. NCQA is the primary accrediting agency for HMOs, and accreditation involves an evaluation of a health plan's procedures to determine if they meet the defined criteria.

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Ulysses

9 days ago

I think A is true because NCQA is well-known for accrediting HMOs.

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