Exam 8: Understanding Medicaid

In order to be eligible for SSI,the individual must meet all of the following criteria,except:

The federal government establishes broad national guidelines for Medicaid eligibility and each state establishes its own eligibility standards within federal guidelines.

The name of the law Congress enacted in 1996 to ensure public access to emergency services regardless of ability to pay is:

States have the option to charge higher copayments for people who visit a hospital emergency department for treatment of a condition that is not considered a true emergency.

All healthcare providers in all states must accept Medicaid patients.

Providers can reduce the number of denied claims by using:

A new rule under the DRA that imposes copayments and premiums to certain categories of Medicaid recipients is referred to as ___________.

List typical responsibilities of a Medicaid contractor (fiscal intermediary).

The Deficit Reduction Act (DRA)of 2005 provided states with the option of imposing ________ to certain categories of Medicaid recipients.

To qualify for Medicaid,the individual must be at least 65 years of age.

Congress established the Medicaid program under Title XIX of the Social Security Act in 1965.

The acronym for the Medicaid program that was formerly referred to as AFDC is:

Groups who are exempt from paying cost shares of fees and/or premiums are limited to children.

One method of verifying Medicaid eligibility is the "automated voice response system."

In 1972 federal law established the supplemental security income (SSI)program.What does it provide?

Third-party liability (TPL)refers to the legal obligation of third parties to pay all or part of the expenditures for medical assistance furnished under a state plan.

All states provide healthcare coverage to pregnant women with qualifying family income.

A state option that provides individuals with disabilities who are eligible for nursing homes and other institutional settings with options to receive community-based services.

Medicaid PAR providers must accept the Medicaid reimbursement as payment in full and cannot balance bill.

Discuss Medicaid Quality Practices