AHM-530 Exam Dumps | Federal laws--including the Ethics in Patient Referrals Act, the Health Maintenance Organization (HMO)

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Question 81/121

Federal laws--including the Ethics in Patient Referrals Act, the Health Maintenance Organization (HMO) Act of 1973, the Employee Retirement Income Security Act (ERISA), and the Federal Trade Commission Act--have impacted the ways that health plans conduct business. For instance, the Mosaic Health Plan must comply with the following federal laws in order to operate:
Regulation 1: Mosaic must establish a mandated grievance resolution mechanism, including a method for members to address grievances with network providers.
Regulation 2: Mosaic must not allow its providers to refer Medicare and Medicaid patients to entities in which they have a financial or ownership interest.
From the answer choices below, select the response that correctly identifies the federal legislation on which Regulation 1 and Regulation 2 are based.

A. Regulation 1 - The HMO Act of 1973 Regulation 2 - The Ethics in Patient Referrals Act

B. Regulation 1 - The Ethics in Patient Referrals Act Regulation 2 - The HMO Act of 1973

C. Regulation 1 - ERISA Regulation 2 - The Federal Trade Commission Act

D. Regulation 1 - The Federal Trade Commission Act Regulation 2 - ERISA

Correct Answer: A

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