AHIP Governance and Regulation AHM-510 Question # 24 Topic 1 Discussion

AHIP Governance and Regulation AHM-510 Question # 24 Topic 1 Discussion

AHM-510 Exam Topic 1 Question 24 Discussion:
Question #: 24
Topic #: 1

Several states have adopted clinical practice guidelines for treating workers' compensation injuries. Clinical practice guidelines can best be described as


A.

Fee schedules that specify the maximum amount providers may charge for treating workers' compensation patients


B.

A utilization management and quality management mechanism designed to aid providers in making decisions about the most appropriate course of treatment for a specific case


C.

Detailed plans of medical treatment designed to facilitate a patient's return to the workplace


D.

Payment practices that might technically violate the provisions of the anti-kickback statute but that will not be considered illegal and for which providers and health plans will not be subject to penalties


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