Governance, Legal Issues, Medicare & Medicaid (AHM510)

Effective governance and an understanding of the legal issues that underpin our nation’s government health care programs are essential to the effort to deliver better health care experiences. To help you better-serve your members and clients, AHIP’s Governance, Legal Issues, Medicare & Medicaid (AHM510) online course will arm you with an in-depth understanding of these areas and much more.

At a Glance

  • 26-hour course length, plus 1 exam
  • Students have up to 180 days to complete course
  • Counts toward FAHM® professional designation
  • Flexible, self-paced online format
  • Mobile-friendly
  • Technical support available by phone or email

What You’ll Learn

  • Explore factors shaping the health insurance industry, its formation, types of insurance, and structure
  • Understand how health insurance providers use reorganization, reengineering, and strategic planning to improve performance
  • Examine legal issues faced by health insurance providers in a post-reform environment
  • Understand the legal issues surrounding ERISA, pharmacy benefits, and wellness
  • Delve into federal and state regulatory requirements that affect health insurance providers
  • Learn the role of the federal government as a purchaser of health care benefits
  • Dig deep into the role of health insurance providers in providing services to both Medicare and Medicaid enrollees
  • Analyze how fraud and abuse affect health care’s cost and quality
  • Explore how health insurance providers use organizational control systems to build internal structures that meet external demands for accountability
  • Review relevant terms, industry issues, case scenarios and concepts

Who Should Take This Course

  • Agents and brokers
  • Case managers
  • Financial planners
  • Health insurance provider staff
  • Medical directors
  • Medical management staff


To enroll in a course, please log in and browse our online catalog. If you are a new user, please create an account to get started.

For even greater ROI, contact our experts at or call the Support Team at 800.509.4422. We can create a custom blend of courses, test prep classes, and group sessions that make the most sense for you and your budget.

Interested in getting the AHIP member rate for this course? Learn about becoming an Individual Member and sign up here!

Earn a Career-Driving Professional Designation

This course is good toward earning the following designation:


Governance, Legal Issues, Medicare & Medicaid (AHM510) is brought to you by the Academy for Healthcare Management (AHM). Sponsored by America’s Health Insurance Plans and the Blue Cross Blue Shield Association, AHM relies on both associations’ decades of experience providing continuing education for health insurance plan professionals. AHM serves more than 1,300 health insurance plans caring for and providing coverage to more than 200 million people.