Exam Name: Governance and Regulation
Certification Provider: AHIP
Corresponding Certification: AHIP Certification
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What is the duration of the AHM-510 Exam
- Format: Multiple choices, multiple answers
- Number of Questions: 76
- Length of Examination: 90 minutes
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Reference: https://www.ahip.org/course/governance-and-regulation-ahm-510/
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AHIP AHM-510 Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Topic 1: Health Insurance Industry Environment and Structure | - Strategic planning, reorganization, and performance improvement - Factors shaping the health insurance industry - Formation, types, and structure of health plans |
| Topic 2: Governance, Compliance, and Integrity | - Organizational governance and internal control systems - Accountability and regulatory reporting standards - Fraud, waste, and abuse prevention and detection |
| Topic 3: Government Healthcare Programs | - Medicare program structure and requirements - Federal government role as purchaser of health benefits - Medicaid program structure and requirements |
| Topic 4: Legal and Regulatory Framework | - Federal and state regulatory compliance requirements - ERISA, pharmacy benefits, and wellness program regulations - Key legal issues in post-healthcare reform environment |
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