What is the difference between Medicare and Medicaid Quizlet?
Terms in this set (27) Medicare is the government-sponsored healthcare program for qualified seniors and the disabled. Medicaid is a joint state and federal healthcare program for qualified individuals who lack resources to pay for healthcare. The Department of Health and Human Services (DHHS) is the federal agency tasked with governing and ...
What are the three main characteristics of the Medicare population?
2.) The federal government matches at least 100% of what a state spends on Medicaid. This amount is larger in states with poorer populations. This ratio is known as the FMAP. 3.) The federal government pays an average of between 57 - 60% of Medicaid program costs and as high as 75% in some states. 4.)
What are the different types of Medicare benefits?
d) Elderly. e) Pharmacy students. a) Children. Which of the following categories would make a person eligible for Medicaid. a) Family of 4 with an income of $200,000. b) Pregnant women and children under 6 in a low income household. c) Only Employed single men. d) Only pharmacy students. e) Only college athletes.
Why do Medicaid eligibility and benefits vary from state to state?
In purchasing health insurance, which of the following is not typically a consideration? ... Childrens Health Insurance, Medicare, Medicaid. ... Other Quizlet sets. Biol 313 Animal Science …
How much does the federal government pay for medicaid?
The federal government pays an average of between 57 - 60% of Medicaid program costs and as high as 75% in some states. 4.) States have large discretion over who is eligible and what services are covered. Therefore, states largely determine how much federal subsidies they will/are willing to receive.
Which is the primary payer for inpatient hospital services?
4.) While Medicare is the nation's primary payer of inpatient hospital services to the elderly and people with ESRD, Medicaid is the nation's primary public payer of acute health, mental health, and long-term care services.
When do seniors have to enroll in Medicare?
All seniors must enroll in the Medicare program within 3 months before or after turning 65
When will the Hospital Insurance Trust Fund be solvent?
2.) These tax dollars are placed in the Hospital Insurance Trust Fund, which is projected to be solvent through 2030
Who must accept an individual market plan?
b. Health insurance issuers must accept any individual and employer who applies for an individual market or group market plan, subject to certain exceptions.
Why do you need to use a colleague's log-in credentials?
a. Requirement to use a colleague's log-in credentials so you can continue to assist consumers with eligibility determinations and enrollments through the Marketplace
What is CMS's focus?
Centers for Medicare and Medicaid Services (CMS) has implemented some powerful tools that shift the focus from a "pay and chase" approach to a prospective approach that looks to prevent fraud, not only in CMS, but collaboratively with state and law enforcement partners that work on detecting and preventing fraud.
How much money did CMS recover in 2012?
The results of the efforts of CMS have been positive. In 2012, the federal government recovered a record $4.2 billion dollars from people who attempted to defraud seniors and taxpayers.
What is the purpose of PPACA?
This title of the PPACA enables patients to be better informed decision makers by requiring nursing homes to provide better quality care, cracking down on fraud and abuse, and disallowing fraudulent providers from relocating their practice to a different state.
What is a health summary?
An easy-to-understand summary provided to consumers about a health plan's benefits and coverage.
Is quality of care fraud?
Quality of care concerns are considered fraud and these concerns can be addressed by a Quality Improvement Organization.
Is Medicare fraud a problem?
According to the Medicare Learning Network, Medicare fraud and abuse is a serious problem and requires all of our attention.
Which age group has the highest medical expenses?
The age group associated with the highest medical expenses is. Adults ages 65 and older. Factors that contribute to escalating health care expenditures in the U.S. include (choose all that apply) Technology Chronic disease An excess of primary care doctors The uninsuredDefinition. A physician operating under the Patient Centered Medical Home model ...
What are the levels of public health?
In general, there are three levels of public health - local, state, and federal. True. Which of the following statements about public health reporting is NOT true: Nationally Notifiable Diseases (NND) are decided upon by CDC and the states must comply.
Is the CDC data true or false?
The data that states send to CDC contains patient identifiers (true/false) False. The increase in average life expectancy in the U.S. since 1900, about 30 years, is primarily due to public health initiatives. True. In general, there are three levels of public health - local, state, and federal. True.
Is hazardous waste management a public health function?
Hazardous waste management is not a function of environmental public health.