AHIP AHM-510 : Governance and Regulation

  • Exam Code: AHM-510
  • Exam Name: Governance and Regulation
  • Updated: Sep 05, 2026
  • Q & A: 76 Questions and Answers

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Who should take the AHM-510 exam

  • Financial executives working with clients looking to maximize their health dollars
  • Agents and brokers who expert in life and health insurance
  • Medical management employees working in hospitals, health systems, and, health insurance plans
  • Employees who work for health care providers or health insurance plans and want to get the educational background to proceed with a management position in the industry
  • Teachers at the school level who teach health care administration
  • Case administrators and medical directors who inquire a broader administrative background
  • candidate who possesses the professional experience in AHIP Governance is eligible for this exam

Certification Path

The Governance and Regulation AHM-510 Exam certification path includes only one AHM-510 certification exam.

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

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AHIP AHM-510 Exam Syllabus Topics:

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

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