- (Topic 3)
An HMO’s quality assurance program must include

1. A. A statement of the HMO’s goals and objectives for evaluating and improving enrollees’ health status
2. B. Documentation of all quality assurance activities
3. C. System for periodically reporting program results to the HMO’s board of directors, its providers, and regulators
4. D. All the above

Correct Answer: D

- (Topic 3)
Combined system of preventive, diagnostic and therapeutic measures that focuses on management of specific chronic illness or medical conditions are:

1. A. Utilization Review
2. B. Case Management
3. C. Demand Management
4. D. Disease management

Correct Answer: B

- (Topic 2)
Medicare Part C can be delivered by the following Medicare Advantage plans:

1. A. HCCP, HMO, PPO (local or regional), PFFS or MSA.
2. B. CCPs, PFFS or MSA.
3. C. HMO, HSA, PPO (local or regional), PFFS or MSA.
4. D. HMO, PPO (local or regional), POS, or MSA.

Correct Answer: B

- (Topic 1)
Emily Brown works for Integral Health Plan and represents the company as a board member for the board of directors. Which best describes Emily's position?

1. A. Community Representative
2. B. Inside Director
3. C. Outside Director
4. D. None of these

Correct Answer: B

- (Topic 2)
One true statement regarding ethics and laws is that the values of a community are reflected in

1. A. both ethics and laws, and both ethics and laws are enforceable in the court system
2. B. both ethics and laws, but only laws are enforceable in the court system
3. C. ethics only, but only laws are enforceable in the court system
4. D. laws only, but both ethics and laws are enforceable in the court system

Correct Answer: B