Absolute Free AHM-540 Exam Practice for Comprehensive Preparation 

Comorbidity can have a significant impact on the effective implementation of disease management programs. Comorbidity can correctly be defined as the

A health plan’s coverage policies are linked to its purchaser contracts. The following statement(s) can correctly be made about the purchaser contract and coverage decisions: 1. In case of conflict between the purchaser contract and a health plan’s medical policy or benefits administration policy, the contract takes precedence 2. Purchaser contracts commonly exclude custodial care from their coverage of services and supplies 3. All of the criteria for coverage decisions must be included in the purchaser contract  

Ms. Ray’s condition, her physician has prescribed Upzil, a medication that has Food and Drug

Administration (FDA) approval only for the treatment of depression. Upzil has not been tested for

safety or effectiveness in the treatment of migraine headache. Although Harbrace’s medical policy

for migraine headache does not include coverage of Upzil, Harbrace has agreed to provide extracontractual

coverage of Upzil for Ms. Ray.

In this situation, the prescribing of Upzil for Ms. Ray’s headaches is an example of 

For this question, if answer choices (A) through (C) are all correct, select answer choice (D). Otherwise, select the one correct answer choice. The QAPI (Quality Assessment Performance Improvement Program) is a Centers for Medicaid and Medicare Services (CMS) initiative designed to strengthen health plans’ efforts to protect and improve the health and satisfaction of Medicare beneficiaries. QAPI quality assessment standards apply to

contract with pharmacy benefit managers (PBMs). Functions that a PBM typically performs for a

health plan include

1. Managing the costs of prescription drugs

2. Promoting efficient and safe drug use

3. Determining the health plan’s internal management responsibilities for pharmacy services