Exam 1: Introduction to Health Care Systems

Under this care model, the primary care physician acts as a "gatekeeper" to coordinate the patient care across providers by addressing preventive, acute, and chronic care needs and by providing the patient with access to electronic tools.

A Health Information Exchange links data provided by various health care providers.

A program designed by CMS to recover improper Medicare payments is named _______________.

Federal and state governments jointly fund the Medicaid program.

The American College of Surgeons was one of the first organizations to establish standards for hospitals.

This law, passed in 2010, expanded Medicaid eligibility requirements.

Match each description with the correct item - This identifies and investigate malicious fraud within seven geographic zones.

Under HIPAA, it is permissible to use or disclose PHI without a specific written authorization when it is necessary for ____________________.

__________provides medical assistance to lower-income individuals and families. Federal and state governments jointly fund this program.

​___________________________________ is the federal agency within the Department of Health and Human Services that administers the Medicare and Medicaid programs.​

Match each description with the correct item - A third-party entity working under the direction of CMS to detect improper Medicare payments through review of providers' medical records and Medicare claims data.

Match each description with the correct item - Also known as the "Hospital Survey and Construction Act," enacted by Congress in 1946, this legislation provided federal money to determine the need for more hospitals and to pay for their construction.

Under this type of program, reimbursement may be rewarded or penalized based upon the provider's ability to meet pre-established targets for delivery of health care services.

Match each description with the correct item - Enacted as part of the "Stimulus Act" in 2009 to promote the adoption and meaningful use of health information technology, this legislation amended the HIPAA privacy and security rules by introducing additional privacy regulations, breach notification rules, and stiffer civil and criminal penalties for security violations.

The Joint Commission created a_______ program to help accredited health care institutions focus upon specific patient safety concerns.​

Which of the following is NOT one of the administrative simplification provisions of HIPAA?

Match each description with the correct item - Non-profit organizations called for by ARRA and initially funded by federal grants to provide health information technology support to providers to help them become meaningful users of certified electronic health record technology.

Under the American Recovery and Reinvestment Act (ARRA), providers that fail to demonstrate meaningful use for health information technology will be financially penalized.

What benefits does telemedicine provide for a patient?​

In a ______________ system the health care provider charges and is paid for each item of service provided.