WGU D052 Navigating Care Across the Continuum(273 questions and answers)

WGU D052 Navigating Care Across the
Continuum(273 questions and answers)



Social Security Act governs what - answer governs funding and
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requirements for Medicare, Medicaid, CHIP, and more.
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HIPAA and the HITECH Act protect what? - answer protect
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patient privacy, requiring healthcare organizations to implement
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measures to keep patient records secure.
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The False Claims Act - answer makes it illegal to file a false claim
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for funds from a federal program.
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The Patient Protection and Affordable Care Act implemented
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what? - answer implemented new requirements for insurance,
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Medicaid, and more.
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The Drug Enforcement Administration and the Food and Drug
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Administration regulate what? - answer regulate the creation and
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distribution of medication.
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The Department of Health and Human Services and the Office of
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the Inspector General help protect against what?. - answer Fraud
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,True or False. Medicare and Medicaid regulations occur at both
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state and federal levels. - answer True
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Occupational Safety and Health Administration and the Equal || || || || || || ||


Employment Opportunity Commission oversee What?? regulations.
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- answer Workplace regulations
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KNOW your shared decision and patient centered models !! FOr
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this class (from FB page) - answer
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Mike Armstrong - answer Advocate for patient safety after having a
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blood test mis-read that showed he had leukemia. Donated over 15
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million dollars to John Hopkins to develop programs for patient
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safety and diagnostic excellence.
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Common reason for data breaches of PHI - answer criminal attacks
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(cyber attacks)
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HIPAA security rule covers what - answer PHI (electronic format)
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of medical records
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When considering the regulatory requirements for healthcare,
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which agencies primarily oversee the use of medication? - answer
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FDA and DEA
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,Medicare and Medicaid focus on specific groups of people.
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Individuals over the age of 65 and disabled individuals are the
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current focus of what? - answer Medicare
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Medicare = - answer Federal coverage for people over 65, certain
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people under 65 with disabilities and people of any age with end
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stage renal disease
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Medicaid = - answer Cooperative federal and state healthcare
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coverage for low-income adults, pregnant women, and children
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Medicare part ||




Part A ||




Part B ||




Part C ||




Part D - answer Part A-Hospital Insurance
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Part B-Medical Insurance
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Part C- Medicare Advantage (HMO includes A&B)
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Part D- Prescription Drug
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Qualified Medicare Beneficiary (QMB) Program: - answer Helps
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pay premiums, deductibles, coinsurance, and copayments for Part
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A, Part B, or both programs
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, Specified Low-Income Medicare Beneficiary (SLMB) Program: -
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answer Helps pay Part B premiums
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Qualifying Individual (QI) Program: - answer Helps pay Part B
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premiums
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Qualified Disabled Working Individual (QDWI) Program: - answer
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Pays the Part A premium for certain disabled and working
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beneficiaries who have disabilities
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Medicare Part A helps cover what - answer Inpatient hospital care
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● Skilled nursing facility care ● Hospice care ● Home health care
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Medicare Part B helps cover what - answer Services from doctors
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and other health care providers ● Outpatient care ● Home health
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care ● Durable medical equipment ● Many preventive services
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Medicare Part C covers what - answer includes all benefits and
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services covered under Part A and Part B and may include extra
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benefits and services for an extra cost.
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Medicare part D covers - answer helps cover the cost of
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Prescription drugs
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Name other types of healthcare coverage - answer Private insurance
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coverage (such as group health plan or retiree coverage) ●
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