AAPC CPB Medical Billing Chapter 1 Intro to Healthcare Exam 2023

Stablization Act - 1942 - Answer- 1. Wages and price controls were placed on employers 2. Congress limited the wages that could be offered, but allowed the adoption of employee insurance plans Internal Revenue Code - 1954 - Answer- Stated employer contributions to employee health plans were exempt from employee taxable income When was Medicare established? - Answer- 1965 Medicare Part A - Answer- The part of the Medicare program that pays for hospitalization, care in a skilled nursing facility, home health care, and hospice care. When are you eligible for medicare? - Answer- Age 65 Medicare Part B - Answer- The part of the Medicare program that pays for physician services, outpatient hospital services, durable medical equipment, and other services and supplies. HMO - Answer- health maintenance organization What was the purpose of health maintenance organization? - Answer- 1. To try help try to control healthcare cost 2. Overode state laws that prohibited the establishment of prepaid health plans 3. Required employers with 25 or more employees to offer an HMO option if they furnished healthcare coverage to their employees HIPPAA - Answer- Health Insurance Portability and Accountability Act What did HIPPA provide? - Answer- 1. Rights and protections for participants and beneficiaries of group health plans 2. exclusions for pre-existing conditions were limited, and discrimination against employees and dependents basted on their health status were prohibited HCFAC - Answer- Health Care Fraud and Abuse Control Program What is the health care fraud and abuse control program? - Answer- a far reaching program to combat fraud and abuse in healthcare including both public and private health plans What was HCFAC designed to do? - Answer- coordinate federal, state and local law enforcement activities with respect to healthcare fraud and abuse HHS - Answer- Health and Human Services DOJ - Answer- Department of Justice What is required annually from the HHS and DOJ? - Answer- annual report detailing the efforts and recoveries made by the HCFAC program HIPPAA Administrative Simplification provisions required what? - Answer- Sections of the law be publicized to explain the standards for the electronic exchange, privacy, and security of health information Privacy rule of HIPAA - Answer- -protects all individually identifiable health information held or transmitted by a hospital (or other covered entity/business associate) in any form of media. -privacy rule call this information protected health information (PHI) PHI - Answer- Protected Health Information Examples of common identifiers - Answer- - demographic data, name, address, birth date, and social security numbers. - Also includes information relates to an individual's past, present, and future physical or mental health or condition - the provision of health care to the individual - the past, present, or future payment for the provision of healthcare to the individual