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Question ID 17148

Health plans are allowed to appeal rules or regulations that affect them. Generally, the
grounds for such appeals are limited either to procedural grounds or jurisdictional grounds.
The Kabyle Health Plan appealed the following new regulations:
Appeal 1 - Kabyle objected to this regulation on the ground that this regulation is
inconsistent with the law.
Appeal 2 - Kabyle objected to this regulation because it believed that the subject matter
was outside the realm of issues that are legal for inclusion in the regulatory agency's
regulations.
Appeal 3 - Kabyle objected to the process by which this regulation was adopted.
Of these appeals, the ones that Kabyle appealed on jurisdictional grounds were

Option A

Appeals 1, 2, and 3

Option B

Appeals 1 and 2 only

Option C

Appeals 1 and 3 only

Option D

Appeals 2 and 3 only

Correct Answer B
Explanation


Question ID 17149

The Opal Health Plan complies with all of the provisions of the Newborns' and Mothers'
Health Protection Act of 1996 (NMHPA). Samantha Hill and Debra Chao are Opal
enrollees. Ms. Hill was hospitalized for a cesarean birth, and Ms. Chao was hospitalized for
a normal delivery. From the following answer choices, select the response that indicates
the minimum hospital stay for which Opal, under NMHPA, must provide benefits for Ms. Hill
and Ms. Chao.

Option A

 Ms. Hill: 72 hours; Ms. Chao: 24 hours

Option B

Ms. Hill: 72 hours; Ms. Chao: 48 hours

Option C

Ms. Hill: 96 hours; Ms. Chao: 24 hours

Option D

Ms. Hill: 96 hours; Ms. Chao: 48 hours

Correct Answer D
Explanation

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