CMS MEDICARE MEDICAID EXAM ACTUAL UPDATE QUESTIONS AND VERIFIED ANSWERS.

CMS MEDICARE MEDICAID EXAM
ACTUAL UPDATE QUESTIONS AND VERIFIED ANSWERS




CMS - ANSWER Centers for medicare and medicaid services



History of Medicare and medicaid - ANSWER Social security amendments of 1965--programs
signed into law



Medicare modernization act of 2003--added an outpatient prescription drug benefit and made
other changes.



3 parts of the department of health and human services: - ANSWER 1. Health resources services
and administration (public health service)



2. Indian health services



3. Centers for Medicare and Medicaid (CMS)--formerly HCFA (health care financing
administration



CMS has 2 components: - ANSWER 1. Medicare

--Medicare hospital part A (hospital, SNF, hospice, HH)

--Medicare physician services part B (office visits, HH)

--Medicare advantage part C (private insurer for A and B, usually D)

--prescription drug plans part D (private insurer)

,2. Medicaid and SCHIP

--the state children's health insurance program more commonly referred to now as the
children's health insurance (CHIP) is a program administered by the department of health and
human services that provides matching funds to states to families with children. It was designed
to cover uninsured children in families with incomes that are modest but too high to qualify for
Medicaid.



Medicare is for 3 groups of people: - ANSWER 1. 65 and older

2. Under 65 with certain disabilities (receiving social security disability for at least 24 months)

3. Specific disease (any age with end-stage renal disease (ESRD) or receiving regular dialysis, or
with diagnosis of amyotrophic lateral sclerosis (ALS)



How is Medicare administered? - ANSWER Centers for Medicare and Medicaid services



How are you enrolled for Medicare? - ANSWER Social security administration for most



Railroad retirement board (RRB) enrolls railroad retirees.



What is the largest health insurer in the country? And how is it financed? - ANSWER Medicare.
Primarily financed by taxes.



Medicare categorizes patients into.... - ANSWER Defined diagnosis-related groups (DRGs) with
fixed reimbursement schedules.



How many parts does Medicare have? - ANSWER 4: part A-D



Part A of Medicare is what and covers.... - ANSWER Hospital insurance. Helps cover inpatient
care in hospitals and SNF, hospice, and home health care.

, Part B of Medicare is what and covers.... - ANSWER Medical insurance. Helps cover doctor's
services, outpatient care, home health care and some preventive services.



Part C of Medicare is what and covers.... - ANSWER Medicare advantage plans. Another way to
get Medicare benefits. Combines parts A and B. Usually includes part D coverage. Run by private
insurance companies approved by and under contract with Medicare.



What is part D of Medicare and what does it cover? - ANSWER Medicare prescription drug
coverage. Helps cover the cost of prescription drugs. Run by private insurance companies
approved by and under contract with Medicare.



Medicare part A helps pay for..... - ANSWER 1. Hospital stays (semiprivate room, meals, nursing
and other hospital services and supplies)

2. SNF care (semiprivate room, meals nursing and rehab services)

3. Home health care services (skilled care, PT, OT and speech.)

4. Hospice care (drugs and medical, support services).

5. Blood



Medicare part A will pay for skilled nursing facility care for people who meet ALL of the
following conditions: - ANSWER Require daily skilled services (not just long term or custodial
care)



Inpatient in a hospital 3 consecutive days or longer



Admitted to the SNF within 30 days after leaving hospital



Care is for a condition that was treated in the hospital