AHIP AHM-510 - Governance and Regulation

AHIP AHM-510 Actual PDF
  • Exam Code: AHM-510
  • Exam Name: Governance and Regulation
  • Updated: Sep 12, 2026
  • Q & A: 76 Questions and Answers
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About AHIP AHM-510 Exam

The benefit in Obtaining the AHM-510 Exam Certification

  • By passing the AHM-510 exam will give candidates a sense of personal accomplishment and the respect of colleagues in their organization and throughout the industry.
  • Candidates can get knowledge and skills that help them to succeed in the rapidly changing and evolving healthcare industry.
  • By passing in Governance and Regulation AHM-510 Exam, Candidates can be participating in a new and exciting course. Candidate's participation will signify their commitment to professionalism.
  • By passing, AHM-510 exam candidate can add a new dimension to his career experience and distinguish himself as a person who is knowledgeable about the environment, products, operations, and issues of the health insurance plan industry.
  • Candidates can learn unique complexities associated with health plans and being the update in knowledge with the latest trends, developments, and practices.

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Governance and Regulation AHM-510 Exam

Governance and Regulation AHM-510 Exam is designed by the Academy of Health Care Administration (AHM) and sponsored by the US Health Insurance Plans and the Blue Cross Blue Shield Association. AHM is a self-study examination based program. AHM-510 Exam validates candidate has the knowledge of types, and structure of health management organizations. This exam also verifies the candidate has a strong understanding of the role of healthcare administration in government-sponsored programs, such as Medicare and Medicaid. Candidates also know about the overall purpose and direction of healthcare management, the impact of fraud and abuse, and the role of public policy. In addition, the Candidate must have the ability to handle legal issues related to ERISA, pharmacy benefits, and wellness programs.

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What is the duration of the AHM-510 Exam

  • Number of Questions: 76
  • Length of Examination: 90 minutes
  • Format: Multiple choices, multiple answers

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

AHIP AHM-510 Exam Syllabus Topics:

SectionObjectives
Topic 1: Health Care Management Organizations and Industry Structure- Formation and evolution of health care management organizations
  • 1. History and development of managed care
    • 2. Factors shaping the health insurance industry
      • 3. Types of health plans and organizational structures
        Topic 2: Legal Issues in Health Care Management- Health care law and regulation
        • 1. Antitrust considerations
          • 2. ERISA-related legal issues
            • 3. Contract law
              • 4. Liability and negligence
                - Privacy and compliance
                • 1. HIPAA privacy requirements
                  • 2. Security and confidentiality of health information
                    • 3. Fraud, waste, and abuse prevention
                      Topic 3: Governance and Organizational Control- Corporate governance
                      • 1. Executive leadership and accountability
                        • 2. Board of directors roles and fiduciary responsibilities
                          • 3. Corporate ethics and compliance culture
                            - Organizational management
                            • 1. Reorganization and reengineering
                              • 2. Strategic planning
                                • 3. Organizational control systems
                                  Topic 4: Government Programs and Public Policy- Medicaid
                                  • 1. Program administration
                                    • 2. Managed Medicaid models
                                      - Public policy and regulation
                                      • 1. Health care reform and regulatory trends
                                        • 2. Government as a purchaser of health care
                                          • 3. Federal and state regulatory requirements
                                            - Medicare
                                            • 1. Role of managed care organizations
                                              • 2. Program structure and benefits

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