• Exam Code: AHM-510
  • Exam Name: Governance and Regulation
  • Certification Provider: AHIP
  • Corresponding Certification:AHIP Certification
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The Governance and Regulation AHM-510 Exam certification path includes only one AHM-510 certification exam.

AHM-510 Exam topics

Candidates must know the exam topics before they start of preparation. Because it will really help them in hitting the core. Our AHM-510 exam dumps will include the following topics:

  • Key legal issues in health plans
  • Federal and state regulatory requirements that effect health plans
  • Important factors shaping the environment of the health plan industry

Reference: https://www.ahip.org/course/governance-and-regulation-ahm-510/

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AHIP AHM-510 Exam Syllabus Topics:

SectionObjectives
Topic 1: Regulatory Environment in Health Insurance- Federal regulation
  • 1. Affordable Care Act (ACA) requirements
    • 2. ERISA regulations
      • 3. HIPAA privacy and security rules
        - State regulation
        • 1. State insurance commissioners and oversight
          • 2. State benefit mandates
            Topic 2: Compliance and Legal Requirements- Legal and ethical obligations
            • 1. Consumer protection requirements
              • 2. Ethical standards in insurance operations
                - Compliance programs
                • 1. Fraud, waste, and abuse prevention
                  • 2. Internal compliance monitoring
                    Topic 3: Health Insurance Governance Framework- Corporate governance structures
                    • 1. Organizational governance models
                      • 2. Risk management governance
                        - Roles and responsibilities of governing bodies
                        • 1. Executive management accountability
                          • 2. Board oversight and fiduciary duties

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