HSA REVIEW QUESTIONS CH 7-10, EXAM 1 CH 1-6
REVIEW QUESTIONS, UPDATED ACTUAL QUESTIONS
AND CORRECT ANSWERS
Question:
1. Describe in general terms the implementation phase of public policymaking
Answer:
Involves managing human, financial, and other resources in ways that facilitate achievement of the goals
and objectives embodied in enacted legislation. It is primarily management undertaking
Question:
2. Who is responsible for policy implementation?
Answer:
Executive branch plays central role in policy implementation, legislative branch oversees implementation
and judicial branch referees implementation
Question:
3. Discuss legislative oversight of policy implementation
Answer:
Legislative branch oversight has been mandated since Legislative Reorganization Act of 1946. It is
intended to accomplish:
- Ensure the implementing organizations adhere to congressional intent
- Improve the efficiency, effectiveness, and economy of governments operations
- Access the ability of implementing organizations and individuals to manage and accomplish
implementation, including investigation of alleged instances of inadequate management, waste, fraud,
dishonesty or arbitrary action
- Ensure that implementation of policies reflects the public interest
Question:
4. What are some of the key points in the legislative history of the establishment and evolution of CMS?
Answer:
Created in 1977 where it brought together implementation responsibility and authority for the two largest
federal healthcare programs- Medicare and Medicaid. CHIP was added to its responsibilities in 1997. The
2010 ACA contained numerous provisions affecting CMS role in Medicare, Medicaid, and CHIP including
major expansion of Medicaid program; two year extension on CHIP; est. of new Federal Coordinated
Health Care Office in CMS to improve care for those eligible for both Medicare and Medicaid; payment
reform.
Question:
5. Describe the key functions of CMS's Center for Medicare
,Answer:
-Serves as CMS's focal point for formulation, coordination, integration, implementation, and evaluation of
national Medicare program policies and operations
-Identifies & proposes modifications to Medicare programs and polices
-Coordinates with the Office of Legislation
-Serves as CMS's lead for management, oversight, budget and performance issues relating to Medicare
Advantage and prescription drug plans
-Oversees all CMS interactions & collaborations with key stakeholders relating to Medicare
-Develops strategic plan to accomplish CMS mission and goals and future challenges
-Coordinates with Center of Program Integrity on program vunerabilities
Question:
6. Discuss the challenges CMS faces in managing the health insurance marketplaces
Answer:
-Eligibility systems
-Payment accuracy
-Contractor oversight
-Data security
-Consumer protection
-Coordination
Question:
7. Describe the designing activity in policy implementation
Answer:
This activity involves efforts to establish the agenda implementing organization, plan how to address the
agenda, and organize to carry out the plans.
Question:
8. Describe the federal rule making process
Answer:
The process through which federal agencies develop, amend or repeal rules is an early and vital step in the
policy implementation phase. The federal rulemaking process begins when Congress takes an action that
either requires or authorizes implementing organization in the executive branch to write an issue rules.
Much rule making is driven by formulation phase where new laws or amendments to existing ones
typically require rules to guide implementation.
Question:
9. Describe operating activity in policy implementation
Answer:
At the point of operating policies, those who implement policies are required to follow the rules
promulgated to guide that implementation according to the mandates inherent in the laws. Some
individuals with implementing responsibilities may disagree with the purposes of enacted laws and may
seek to stall, alter or even subvert the laws in there implementation phases. For example if a policy in the
form of a public law is intended to protect people from exposure to toxic substances in their environment,
it's operation entails the activities involved actually providing such protection.
Question:
10. Describe evaluating activity in policy implementation
, Answer:
This activity brings the other elements of implementation full circle and can lead to new rounds of
designing, rulemaking and operating. When managers of implementing organizations evaluate a policy or
some component of it, they are interested in determining its value among other things. Questions include:
is the policy being affectively implemented? How effective is the policy or some component of it? Were
the policy objectives achieved?
Question:
11. List and briefly describe five organizations that support policy evaluating activity
Answer:
1. Agency for Healthcare Research and Quality- Produces evidence to make healthcare more safer, higher
quality, accessible, equitable and affordable. Works with HHS to ensure that evidence is used and
understood.
2. Center for Medicare and Medicaid Innovation- Innovative payment and service delivery models to
reduce program expenditures
3. Government Accountability Office- Investigative arm of congress ( how are tax payers $ being spent)
4. Congressional Budget office- Provides congress with the objective, timely, and nonpartisan analyses
needed for economic and budget decisions and with the information and estimates required for the
congressional budget process.
5. Congressional Research Service- Provides congress with information and analysis that allows them to
make informed decisions.
Question:
12. Discuss rulemaking. Include the role of interest groups in rulemaking
Answer:
A proposed rule is effectively a draft of a rule or set of rules that will guide implementation of a law while
final rules are under development. Rules can be added, deleted, or modified; thus making is an ongoing
component in the life of any public law. Changes in rules often result from interaction between
implementing officials and those the rules affect directly. These interactions are most commonly triggered
by the publication of a proposed rule. Individuals, Health care organizations, and interest groups with a
stake in how a particular is implemented. Because health related public laws often target members of
interest groups, these groups routinely seek to influence rule making. Regulatory policies are implemented
to control the actions, behaviors, and decisions of individulals and organiszations Allocative policies
provide some type of benefit at the expense of others. Lobbying and other forms of influence become
especially intense when some interest group supports a policy or how it will be implemented vs other
groups who oppose it. The result is often influenced by interest group preferences, with the more
politically powerful groups exerting the greatest influence.
Question:
13. Briefly describe the roles played by each of government in policy modification
Answer:
This phase is necessary because perfection eluded to policymakers and the formulation and
implementation phases. Even policy decisions that are correct when they are made must adjust to
accommodate changing circumstances. The legislative branch modifies policy by making and amending
laws, informed by their oversight responsibilities. The executive branch can modify policy through agenda
setting and implementation phases as well as through executive orders. The judicial branch can modify
policy by interpreting and enforcing laws
REVIEW QUESTIONS, UPDATED ACTUAL QUESTIONS
AND CORRECT ANSWERS
Question:
1. Describe in general terms the implementation phase of public policymaking
Answer:
Involves managing human, financial, and other resources in ways that facilitate achievement of the goals
and objectives embodied in enacted legislation. It is primarily management undertaking
Question:
2. Who is responsible for policy implementation?
Answer:
Executive branch plays central role in policy implementation, legislative branch oversees implementation
and judicial branch referees implementation
Question:
3. Discuss legislative oversight of policy implementation
Answer:
Legislative branch oversight has been mandated since Legislative Reorganization Act of 1946. It is
intended to accomplish:
- Ensure the implementing organizations adhere to congressional intent
- Improve the efficiency, effectiveness, and economy of governments operations
- Access the ability of implementing organizations and individuals to manage and accomplish
implementation, including investigation of alleged instances of inadequate management, waste, fraud,
dishonesty or arbitrary action
- Ensure that implementation of policies reflects the public interest
Question:
4. What are some of the key points in the legislative history of the establishment and evolution of CMS?
Answer:
Created in 1977 where it brought together implementation responsibility and authority for the two largest
federal healthcare programs- Medicare and Medicaid. CHIP was added to its responsibilities in 1997. The
2010 ACA contained numerous provisions affecting CMS role in Medicare, Medicaid, and CHIP including
major expansion of Medicaid program; two year extension on CHIP; est. of new Federal Coordinated
Health Care Office in CMS to improve care for those eligible for both Medicare and Medicaid; payment
reform.
Question:
5. Describe the key functions of CMS's Center for Medicare
,Answer:
-Serves as CMS's focal point for formulation, coordination, integration, implementation, and evaluation of
national Medicare program policies and operations
-Identifies & proposes modifications to Medicare programs and polices
-Coordinates with the Office of Legislation
-Serves as CMS's lead for management, oversight, budget and performance issues relating to Medicare
Advantage and prescription drug plans
-Oversees all CMS interactions & collaborations with key stakeholders relating to Medicare
-Develops strategic plan to accomplish CMS mission and goals and future challenges
-Coordinates with Center of Program Integrity on program vunerabilities
Question:
6. Discuss the challenges CMS faces in managing the health insurance marketplaces
Answer:
-Eligibility systems
-Payment accuracy
-Contractor oversight
-Data security
-Consumer protection
-Coordination
Question:
7. Describe the designing activity in policy implementation
Answer:
This activity involves efforts to establish the agenda implementing organization, plan how to address the
agenda, and organize to carry out the plans.
Question:
8. Describe the federal rule making process
Answer:
The process through which federal agencies develop, amend or repeal rules is an early and vital step in the
policy implementation phase. The federal rulemaking process begins when Congress takes an action that
either requires or authorizes implementing organization in the executive branch to write an issue rules.
Much rule making is driven by formulation phase where new laws or amendments to existing ones
typically require rules to guide implementation.
Question:
9. Describe operating activity in policy implementation
Answer:
At the point of operating policies, those who implement policies are required to follow the rules
promulgated to guide that implementation according to the mandates inherent in the laws. Some
individuals with implementing responsibilities may disagree with the purposes of enacted laws and may
seek to stall, alter or even subvert the laws in there implementation phases. For example if a policy in the
form of a public law is intended to protect people from exposure to toxic substances in their environment,
it's operation entails the activities involved actually providing such protection.
Question:
10. Describe evaluating activity in policy implementation
, Answer:
This activity brings the other elements of implementation full circle and can lead to new rounds of
designing, rulemaking and operating. When managers of implementing organizations evaluate a policy or
some component of it, they are interested in determining its value among other things. Questions include:
is the policy being affectively implemented? How effective is the policy or some component of it? Were
the policy objectives achieved?
Question:
11. List and briefly describe five organizations that support policy evaluating activity
Answer:
1. Agency for Healthcare Research and Quality- Produces evidence to make healthcare more safer, higher
quality, accessible, equitable and affordable. Works with HHS to ensure that evidence is used and
understood.
2. Center for Medicare and Medicaid Innovation- Innovative payment and service delivery models to
reduce program expenditures
3. Government Accountability Office- Investigative arm of congress ( how are tax payers $ being spent)
4. Congressional Budget office- Provides congress with the objective, timely, and nonpartisan analyses
needed for economic and budget decisions and with the information and estimates required for the
congressional budget process.
5. Congressional Research Service- Provides congress with information and analysis that allows them to
make informed decisions.
Question:
12. Discuss rulemaking. Include the role of interest groups in rulemaking
Answer:
A proposed rule is effectively a draft of a rule or set of rules that will guide implementation of a law while
final rules are under development. Rules can be added, deleted, or modified; thus making is an ongoing
component in the life of any public law. Changes in rules often result from interaction between
implementing officials and those the rules affect directly. These interactions are most commonly triggered
by the publication of a proposed rule. Individuals, Health care organizations, and interest groups with a
stake in how a particular is implemented. Because health related public laws often target members of
interest groups, these groups routinely seek to influence rule making. Regulatory policies are implemented
to control the actions, behaviors, and decisions of individulals and organiszations Allocative policies
provide some type of benefit at the expense of others. Lobbying and other forms of influence become
especially intense when some interest group supports a policy or how it will be implemented vs other
groups who oppose it. The result is often influenced by interest group preferences, with the more
politically powerful groups exerting the greatest influence.
Question:
13. Briefly describe the roles played by each of government in policy modification
Answer:
This phase is necessary because perfection eluded to policymakers and the formulation and
implementation phases. Even policy decisions that are correct when they are made must adjust to
accommodate changing circumstances. The legislative branch modifies policy by making and amending
laws, informed by their oversight responsibilities. The executive branch can modify policy through agenda
setting and implementation phases as well as through executive orders. The judicial branch can modify
policy by interpreting and enforcing laws
