Society For Human Resource Management (SHRM) Certified Professional Practice Exam

Can a fee for services or FFS plan be interpreted entirely as a health care plan?

1. Yes, in all situations

2. This varies based on what the FFS covers

3. No, in all situations

4. No, it is not offered by a worker

The correct answer is: No, it is not offered by a worker

The interpretation of a fee-for-service (FFS) plan as a health care plan hinges on the nature of the services provided and who is offering them. A fee-for-service plan typically involves a payment model where a healthcare provider is paid for each specific service rendered to a patient. However, whether it can be classified entirely as a health care plan depends on various factors. In this context, the correct interpretation asserts that a fee-for-service model is not categorized as a health care plan if it is not offered by an entity classified as a worker or healthcare provider. This position highlights the importance of who administers or provides the service. If the services are not provided or managed by a recognized healthcare professional or institution, it cannot be classified as a comprehensive health care plan. Thus, the key component that defines the nature of the FFS plan is its relationship with providers who are responsible for delivering health care services. If this relationship is absent or illegitimate, then categorizing it as a health care plan is not feasible. Understanding this distinction is crucial for interpreting health care frameworks accurately and assessing the validity of various health services offered within different administrative structures.