- (Topic 3)
Calculate the hospital bed days per 1000 members for the Month to date (MTD) on 25 April, with plan membership of 25,000 and total gross hospital bed days in MTD is 300 for an XYZ Health plan?

1. A. 175
2. B. 480
3. C. 1000
4. D. 365

Correct Answer: A

- (Topic 3)
The Meadowcreek Group is an organization comprised of individual physicians and physicians in small group practices. Meadowcreek enters into contracts with health plans, and then Meadowcreek contracts separately with its physician members. In situations w

1. A. a group practice without walls (GPWW)
2. B. a messenger model
3. C. an individual practice association (IPA)
4. D. a Physician Practice Management (PPM) company

Correct Answer: C

- (Topic 1)
Bill Clinton is a member of Lewinsky's PBM plan which has a three-tier copayment structure. Bill fell ill and his doctor prescribed him AAA, a brand-name drug which was included in the Lewinsky's formulary; BBB, a non-formulary drug; and CCC, a generic dr

1. A. CCC, AAA, BBB
2. B. BBB, CCC, AAA
3. C. BBB, AAA, CCC
4. D. CCC, BBB, AAA

Correct Answer: A

- (Topic 1)
In 1999, the United States Congress passed the Financial Services Modernization Act, which is referred to as the Gramm-Leach-Bliley (GLB) Act. The following statement(s) can correctly be made about this act:

1. A. The GLB Act allows convergence among the transaction
2. B. A only
3. C. Both A and B
4. D. B only
5. E. Neither A nor B

Correct Answer: B

- (Topic 1)
Health plans may use different capitation arrangements for different levels of service. One typical capitation arrangement provides a capitation payment that may include primary care only, or both primary and secondary care, but not ancillary services. The

1. A. global capitation arrangement
2. B. gatekeeper arrangement
3. C. carve-out arrangement
4. D. partial capitation arrangement

Correct Answer: D