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NEW QUESTION: 1
The iterative process of increasing the level of detail in a project management plan as greater amounts of information become available is known as:
A. Progressive elaboration.
B. Quality assurance.
C. Continuous improvement.
D. Predictive planning.
Answer: A
NEW QUESTION: 2
The following statements describe two types of HMOs:
The Elm HMO requires its members to select a PCP but allows the members to go to any other provider on its panel without a referral from the PCP.
The Treble HMO does not require its members to select a PCP. Treble allows its members to go to any doctor, healthcare professional, or facility that is on its panel without a referral from a primary care doctor. However, care outside of Treble's network is not reimbursed unless the provider obtains advance approval from the HMO.
Both HMOs use delegation to transfer certain functions to other organizations. Following the guidelines established by the NCQA, Elm delegated its credentialing activities to the NewnanGroup, and the agreement between Elm and Newnan lists the responsibilities of both parties under the agreement. Treble delegated utilization management (UM) to an IPA. The IPA then transferred the authority for case management to the Quest Group, an organization that specializes in case management.
Both HMOs also offer pharmacy benefits. Elm calculates its drug costs according to a pricing system that requires establishing a purchasing profile for each pharmacy and basing reimbursement on the profile. Treble and the Manor Pharmaceutical Group have an arrangement that requires the use of a typical maximum allowable cost (MAC) pricing system to calculate generic drug costs under Treble's pharmacy program. The following statements describe generic drugs prescribed for Treble plan members who are covered by Treble's pharmacy benefits:
The MAC list for Drug A specifies a cost of 12 cents per tablet, but Manor pays 14 cents per tablet for this drug.
The MAC list for Drug B specifies a cost of 7 cents per tablet, but Manor pays 5 cents per tablet for this drug.
The following statements can correctly be made about the reimbursement for Drugs A and B under the MAC pricing system:
A. Manor most likely is allowed to bill the subscriber 2 cents per tablet for Drug A.
B. All of the above statements are correct.
C. Treble most likely is obligated to reimburse Manor 5 cents per tablet for Drug B.
D. Treble most likely is obligated to reimburse Manor 14 cents per tablet for Drug
Answer: C
NEW QUESTION: 3
Which one of the following actions will not help to ensure the fair treatment of brokerage firm clients when a new investment recommendation is made?
A. Distribute recommendations to institutional clients prior to individual accounts.
B. Minimize elapsed time between the decision and the dissemination of a recommendation.
C. Monitor the trading activities of firm personnel.
D. Limit the number of people in the firm who are aware in advance that a recommendation is to be disseminated.
Answer: A
Explanation:
Explanation/Reference:
Explanation:
This question deals with Standard IV (B.3), Fair Dealing. All the procedures listed will help members treat clients fairly, except distributing recommendations to institutional clients prior to individual accounts. This practice discriminates among clients based on size and class of assets and is a violation of Standard IV (B.3).
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