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AHIP AHM-540 Exam - Topic 3 Question 95 Discussion

Posted by Ryan on Aug 27, 2024 at 01:34 AM

Federal laws, such as the Employee Retirement Income Security Act (ERISA), the Balanced Budget Act (BBA) of 1997, and the Health Insurance Portability and Accountability Act (HIPAA), have affected medical management activities by health plans. Consider the following provisions of federal regulations:

Provision 1---Limits damage awards in lawsuits related to noncoverage of benefits based on medical necessity decisions to the cost of noncovered treatment and does not allow health plan members to obtain compensatory or punitive damages

Provision 2---Establishes electronic data security standards, which define the security measures that healthcare organizations must take to protect the confidentiality of electronically stored and transmitted patient information From the answer choices below, select the response that correctly identifies the federal laws that include Provision 1 and Provision 2, respectively.

Suggested Answer: A

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35 comments · newest first
IR
Irene 11 months ago
I’m not sure about that, I thought the BBA had more to do with budget issues.
SI
Silva 11 months ago
Totally agree, ERISA for Provision 1 makes sense.
ME
Melodie 12 months ago
Wait, HIPAA covers data security? I thought it was just about privacy!
IL
Ilene 12 months ago
I think it's actually the BBA for Provision 1, not ERISA.
KA
Katheryn 1 year ago
Provision 1 is definitely ERISA, that's a fact.
RI
Ricki 1 year ago
I thought the Balanced Budget Act was more about funding and less about these specific provisions, so I'm not sure it fits here.
MA
Markus 1 year ago
I practiced a similar question about these laws, but I can't recall which one limits damage awards. I might guess ERISA for Provision 1, though.
TA
Tarra 1 year ago
I'm not entirely sure, but I feel like HIPAA is definitely about data security, which makes me lean towards it being Provision 2.
JO
Josue 1 year ago
I remember ERISA deals with benefits and coverage, so I think Provision 1 might be related to it.
CH
Chan 1 year ago
Ugh, I'm a little confused on the details of these different federal laws and which ones include the specific provisions mentioned. I'll have to re-read the question carefully and try to reason through the best answer.
DE
Desiree 1 year ago
Okay, I see the two provisions listed, and I know those laws cover different aspects of healthcare regulations. I just need to match them up correctly with the right laws. I think I can figure this out.
PA
Paris 1 year ago
I think I've got a good handle on this question. The key is to identify which federal laws include the specific provisions described. I'll carefully read through the options and match them up.
GI
Gilma 1 year ago
Hmm, this is a tricky one. I need to make sure I really understand the differences between ERISA, HIPAA, and the BBA of 1997. I'll have to think it through step-by-step.
HO
Howard 1 year ago
This seems straightforward to me. Based on the information provided, the client is likely performing AD machine authentication, which would result in the MAC address being used as the User-Name. I'll mark that as my answer and move on to the next question.
GE
Gene 1 year ago
I'm feeling lucky with C. The Balanced Budget Act? More like the Balanced Breakfast Act, am I right? *crickets* Okay, tough crowd.
IV
Ivette 1 year ago
A, no doubt. ERISA is the MVP when it comes to limiting lawsuit damages, and HIPAA is the king of data security. This question is a slam dunk!
TH
Thora 1 year ago
↳ replying to Ivette
Couldn't agree more, ERISA and HIPAA are the perfect match for these provisions.
KI
Kizzy 1 year ago
↳ replying to Ivette
A) Provision 1- ERISA Provision 2- HIPAA
IR
Iraida 1 year ago
↳ replying to Ivette
Absolutely, ERISA and HIPAA are the power duo in this scenario.
KE
Keva 1 year ago
↳ replying to Ivette
A) Provision 1- ERISA Provision 2- HIPAA
DE
Devorah 1 year ago
Hmm, this is a tough one. I was tempted to go with B, but then I remembered that HIPAA is all about protecting patient information, not limiting damages. Gotta go with A on this one.
BA
Barb 1 year ago
↳ replying to Devorah
So, A it is then.
VA
Valentin 1 year ago
↳ replying to Devorah
I agree, HIPAA is more about patient information protection.
CA
Catarina 1 year ago
↳ replying to Devorah
I think A is the correct answer.
TO
Toshia 2 years ago
I'm leaning towards C. The Balanced Budget Act of 1997 seems to fit Provision 1, and HIPAA definitely covers Provision 2. But I'm not 100% sure.
CH
Cherry 1 year ago
↳ replying to Toshia
Let's go with C then. It seems to be the best match for both provisions.
LO
Loren 1 year ago
↳ replying to Toshia
I agree, C seems to be the most logical choice based on the provisions mentioned.
AS
Ashley 1 year ago
↳ replying to Toshia
I think C is the correct answer. BBA of 1997 for Provision 1 and HIPAA for Provision 2.
FA
Fabiola 2 years ago
I think the answer is A. ERISA limits damages and HIPAA establishes electronic data security standards. Easy peasy!
TE
Tegan 1 year ago
↳ replying to Fabiola
It's always good to double-check, but I think we got this one right. A it is!
HO
Hortencia 1 year ago
↳ replying to Fabiola
I wasn't sure at first, but now that you explained it, it makes sense. Thanks for clarifying!
GE
German 1 year ago
↳ replying to Fabiola
I agree with you, A is the correct answer. ERISA and HIPAA are the laws that include those provisions.
CA
Casandra 2 years ago
I'm not sure, but I think C) Provision 1- BBA of 1997 Provision 2- HIPAA doesn't sound right.
PE
Pete 2 years ago
I agree with Gussie, ERISA covers Provision 1 and HIPAA covers Provision 2.
GU
Gussie 2 years ago
I think the correct answer is A) Provision 1- ERISA Provision 2- HIPAA.
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