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Question ID 17110

Greenpath Health Services, Inc., an HMO, recently terminated some providers from its
network in response to the changing enrollment and geographic needs of the plan. A
provision in Greenpath's contracts with its healthcare providers states that Greenpath can
terminate the contract at any time, without providing any reason for the termination, by
giving the other party a specified period of notice.
The state in which Greenpath operates has an HMO statute that is patterned on the NAIC
HMO Model Act, which requires Greenpath to notify enrollees of any material change in its
provider network. As required by the HMO Model Act, the state insurance department is
conducting an examination of Greenpath's operations. The scope of the on-site
examination covers all aspects of Greenpath's market conduct operations, including its
compliance with regulatory requirements.
The contracts between Greenpath and its healthcare providers contain a termination
provision known as

Option A

An 'economic credentialing' termination provision

Option B

A 'breach of contract' termination provision

Option C

A 'fair procedure' termination provision

Option D

A 'without cause' termination provision

Correct Answer D
Description
Update Date and Time 2018-01-01 06:48:39

Question ID 17111

The Nonprofit Institutions Act allows the Neighbor Hospital, a not-for-profit hospital, to
purchase at a discount drugs for its 'own use'. Consider whether the following sales of
drugs were not for Neighbor's own use and therefore were subject to antitrust enforcement:
Elijah Jamison, a former patient of Neighbor, renewed a prescription that was originally
dispensed when he was discharged from Neighbor.
Neighbor filled a prescription for Camille Raynaud, who has no connection to Neighbor
other than that her prescribing physician is located in a nearby physician's office building.
Neighbor filled a prescription for Nigel Dixon, who is a friend of a Neighbor medical staff
member.
With respect to the United States Supreme Court's definition of 'own use,' the drug sales
that were not for Neighbor's own use were the sales that Neighbor made to

Option A

Mr. Jamison, Ms. Raynaud, and Mr. Dixon

Option B

 Mr. Jamison and Ms. Raynaud only

Option C

Mr. Dixon only

Option D

None of these individuals

Correct Answer A
Description
Update Date and Time 2018-01-01 06:51:13