Câu 3: AHM-530: Network Management

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.

1. A. Regulation 1 - The Ethics in Patient Referrals ActRegulation 2 - The HMO Act of 1973
2. B. Regulation 1 - The HMO Act of 1973Regulation 2 - The Ethics in Patient Referrals Act — đáp án hiện tại
3. C. Regulation 1 - ERISA -Regulation 2 - The Federal Trade Commission Act
4. D. Regulation 1 - The Federal Trade Commission ActRegulation 2 - ERISA