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Exam 15: Medicaid

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Question 1

Multiple Choice

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When the patient is covered by other medical or liability policies, Medicaid reimburses providers __________.

A) first
B) last

C) A) and B)
D) undefined

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Question 2

Multiple Choice

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Which consists of routine pediatric checkups provided to all children enrolled in Medicaid, including dental, hearing, vision, and other screening services to detect potential problems?

A) early and periodic screening, diagnostic, and treatment
B) health care immunization and vaccination program
C) preventive and maintenance care and screening
D) well baby and well child encounters at provider offices

E) A) and D)
F) None of the above

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Question 3

Multiple Choice

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The Medicare Catastrophic Coverage Act of 1988 implemented Spousal Impoverishment Protection Legislation in 1989 to prevent married couples from being required to spend down income and other liquid assets (cash and property) before one of the partners could be declared eligible for Medicaid coverage for nursing facility care. The spouse residing at home is called the __________ spouse.

In 1965 Congress passed Title 19 of the Social Security Act, establishing a federally mandated, __________-administered medical assistance program for individuals with incomes below the federal poverty level.

The portion of the Medicaid program paid by the federal government is called the Federal Medical Assistance Percentage (FMAP) and is determined annually for each state using a formula that compares __________ average per capita income level with the national average.

A(n) __________ claim has a payment correction, resulting in additional payment(s) to the provider.

The federal name for the Title 19 medical assistance program is __________.

The State Children's Health Insurance Program (SCHIP) was implemented in accordance with the Balanced Budget Act (BBA) to allow states to create or expand existing insurance programs, providing more federal funds to states for the purpose of expanding __________ eligibility to include a greater number of currently uninsured children.

Which describes annual income guidelines established by the federal government?

Which is the special group that requires states to pay Medicare Part A premiums for certain disabled individuals who lose Medicare coverage because of work?

Any time patients state that they receive Medicaid, they must present a valid Medicaid identification card because eligibility, in many cases, will depend on the patient's __________ income.

Programs of All-inclusive Care for the Elderly (PACE) use a capitated payment system to provide a comprehensive package of community-based services as an alternative to institutional care for persons age 55 or older who require a(n) __________ level of care.

Which is the current program that makes cash assistance available, for a limited time, for children deprived of support because of a parent's absence, death, incapacity, or unemployment?

Which allows providers to electronically access the state's eligibility file to verify Medicaid eligibility?

A(n) __________ claim is one that Medicaid should not have originally paid, and results in a deduction from the lump-sum payment made to the provider.

Which is the special group that requires states to pay Medicare premiums, deductibles, and coinsurance amounts for individuals whose income is at or below 100 percent of the federal poverty level and whose resources are at or below twice the standard allowed under SSI?

Any provider who accepts a Medicaid patient must accept the Medicaid-determined payment as __________.

Federal regulations require Medicaid to establish and maintain a(n) __________ program, which safeguards against unnecessary or inappropriate use of Medicaid services or excess payments and assesses the quality of those services.

Which is the special group that requires states to pay Medicare Part B premiums for individuals with incomes between 120 percent and 175 percent of the federal poverty level?

Which is the special group that requires states to pay Medicare Part B premiums for individuals with incomes between 100 and 120 percent of the federal poverty level?