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QUESTION 16

One federal law amended the Social Security Act to allow states to set their own qualification standards for HMOs that contracted with state Medicaid programs and revised the requirement that participating HMOs have an enrollment mix of no more than 50% combined Medicare and Medicaid members.
This act, which was the true stimulus for increasing participation by health plans in Medicaid, is called the

  1. A. Omnibus Budget Reconciliation Act of 1981 (OBRA-81)
  2. B. Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA)
  3. C. Employee Retirement Income Security Act of 1974 (ERISA)
  4. D. Federal Employees Health Benefits Act of 1958 (FEHB Act)

Correct Answer: A

QUESTION 17

Antitrust laws can affect the formation, merger activities, or acquisition initiatives of a health plan. In the United States, the two federal agencies that have the primary responsibility for enforcing antitrust laws are the

  1. A. Internal Revenue Service (IRS) and the Department of Justice (DOJ)
  2. B. Office of Inspector General (OIG) and the Department of Defense (DOD)
  3. C. Federal Trade Commission (FTC) and the Department of Labor (DOL)
  4. D. Federal Trade Commission (FTC) and the Department of Justice (DOJ)

Correct Answer: D

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