Câu 95: AHM-250: Healthcare Management: An Introduction

The NAIC adopted the HMO Model Act in order to provide a system of ongoing regulatory monitoring of HMOs. All of the following statements are correct about the HMO Model Act EXCEPT that it:

1. A. Regulates HMO operations in two critical areas: financial responsibility and healthcare delivery.
2. B. Requires each HMO to send state regulators an annual report describing the HMO's finances and operations.
3. C. Focuses on three key aspects of healthcare delivery: network adequacy, quality assurance, and grievance procedures.
4. D. Requires state insurance departments to conduct annual examinations of an HMO's operations, quality assurance programs, and provider networks. — đáp án hiện tại