Câu 12: AHM-510: Governance and Regulation

QUESTION 35 Health maintenance organizations (HMOs) seeking federal qualification under the HMO Act of 1973 and its amendments must meet requirements in four basic operational areas. One operational requirement for qualification is that an HMO must:

1. A. Ensure that at least 1/3 of its policy-making body is comprised of HMO members
2. B. Ensure that there is adequate representation of underserved communities on its policy-making body
3. C. Have an ongoing quality assurance program that meets the requirements of the Centers for Medicaid & Medicare Services (CMS), stresses health outcomes, and provides for review by health professionals — đáp án hiện tại
4. D. Test, safeguard, and promote quality of care by following detailed programmatic techniques that are explained in CMS's Federally Qualified HMO (FQHMO) Manual