CERTIFIED MEDICAID PLANNER (CMP™) EXAMINATION
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE – THIS YEAR
SECTION 1: MEDICAID PROGRAM STRUCTURE AND FUNDING
(Questions 1–25)
1. A married applicant enters a nursing facility while the spouse
remains at home. Which planning strategy primarily protects the
community spouse from financial hardship?
A. Estate recovery acceleration
B. Spousal impoverishment protections
C. Medicaid waiver enrollment
D. Medicare secondary coverage
Answer: B
Rationale: Federal protections allow the community spouse to retain
certain income and assets while the institutionalized spouse seeks
Medicaid eligibility.
2. Medicaid is primarily funded through which combination of sources?
A. Federal taxes only
B. State taxes only
1
, C. Federal and state governments jointly
D. Private insurance premiums
Answer: C
Rationale: Medicaid is a joint federal-state program. The federal
government provides matching funds (FMAP) to states based on per
capita income, while states administer the program and contribute
their share.
3. The Federal Medical Assistance Percentage (FMAP) determines:
A. The percentage of Medicaid beneficiaries in each state
B. The federal matching rate for state Medicaid expenditures
C. The number of Medicaid waivers available
D. The income threshold for Medicaid eligibility
Answer: B
Rationale: FMAP is the percentage of Medicaid costs the federal
government reimburses to states. It varies inversely with state per
capita income.
4. Which of the following is NOT a mandatory Medicaid eligibility
group?
A. Pregnant women with income below 133% FPL
2
, B. Children under age 6 with income below 133% FPL
C. Childless adults aged 19–64 with income below 138% FPL (expansion
states)
D. Low-income Medicare beneficiaries (dual eligibles)
Answer: C
Rationale: The ACA expansion for childless adults is optional for states;
mandatory groups include pregnant women, children, and dual
eligibles.
5. Medicaid was created under which federal legislation?
A. Social Security Act of 1935
B. Medicare Act of 1965
C. Social Security Amendments of 1965
D. Affordable Care Act of 2010
Answer: C
Rationale: Medicaid was established by Title XIX of the Social Security
Act via the 1965 amendments.
6. States have the option to provide Medicaid coverage to:
A. All individuals below 100% FPL
3
, B. Medically needy individuals with high medical expenses
C. Only SSI recipients
D. Only children and pregnant women
Answer: B
Rationale: The "medically needy" option allows states to cover
individuals whose income exceeds standard limits but is reduced by
high medical costs.
7. The upper payment limit (UPL) in Medicaid refers to:
A. Maximum income a beneficiary can have
B. Maximum federal reimbursement for institutional services
C. Limit on state administrative costs
D. Cap on prescription drug formularies
Answer: B
Rationale: UPL ensures that Medicaid payments to providers do not
exceed what Medicare would pay for similar services.
8. Which entity administers Medicaid at the state level?
A. Centers for Medicare & Medicaid Services (CMS)
B. State Medicaid agency or Department of Health
4
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE – THIS YEAR
SECTION 1: MEDICAID PROGRAM STRUCTURE AND FUNDING
(Questions 1–25)
1. A married applicant enters a nursing facility while the spouse
remains at home. Which planning strategy primarily protects the
community spouse from financial hardship?
A. Estate recovery acceleration
B. Spousal impoverishment protections
C. Medicaid waiver enrollment
D. Medicare secondary coverage
Answer: B
Rationale: Federal protections allow the community spouse to retain
certain income and assets while the institutionalized spouse seeks
Medicaid eligibility.
2. Medicaid is primarily funded through which combination of sources?
A. Federal taxes only
B. State taxes only
1
, C. Federal and state governments jointly
D. Private insurance premiums
Answer: C
Rationale: Medicaid is a joint federal-state program. The federal
government provides matching funds (FMAP) to states based on per
capita income, while states administer the program and contribute
their share.
3. The Federal Medical Assistance Percentage (FMAP) determines:
A. The percentage of Medicaid beneficiaries in each state
B. The federal matching rate for state Medicaid expenditures
C. The number of Medicaid waivers available
D. The income threshold for Medicaid eligibility
Answer: B
Rationale: FMAP is the percentage of Medicaid costs the federal
government reimburses to states. It varies inversely with state per
capita income.
4. Which of the following is NOT a mandatory Medicaid eligibility
group?
A. Pregnant women with income below 133% FPL
2
, B. Children under age 6 with income below 133% FPL
C. Childless adults aged 19–64 with income below 138% FPL (expansion
states)
D. Low-income Medicare beneficiaries (dual eligibles)
Answer: C
Rationale: The ACA expansion for childless adults is optional for states;
mandatory groups include pregnant women, children, and dual
eligibles.
5. Medicaid was created under which federal legislation?
A. Social Security Act of 1935
B. Medicare Act of 1965
C. Social Security Amendments of 1965
D. Affordable Care Act of 2010
Answer: C
Rationale: Medicaid was established by Title XIX of the Social Security
Act via the 1965 amendments.
6. States have the option to provide Medicaid coverage to:
A. All individuals below 100% FPL
3
, B. Medically needy individuals with high medical expenses
C. Only SSI recipients
D. Only children and pregnant women
Answer: B
Rationale: The "medically needy" option allows states to cover
individuals whose income exceeds standard limits but is reduced by
high medical costs.
7. The upper payment limit (UPL) in Medicaid refers to:
A. Maximum income a beneficiary can have
B. Maximum federal reimbursement for institutional services
C. Limit on state administrative costs
D. Cap on prescription drug formularies
Answer: B
Rationale: UPL ensures that Medicaid payments to providers do not
exceed what Medicare would pay for similar services.
8. Which entity administers Medicaid at the state level?
A. Centers for Medicare & Medicaid Services (CMS)
B. State Medicaid agency or Department of Health
4
