OTP 510 Final Exam UPDATED Exam
Questions and CORRECT Answers
The following criteria is required for Medicare services Except - CORRECT ANSWER -
Married and a past contributor to Medicare
This part of medicare covers outpatient, hospital care, short-term skilled nursing facility care,
and home health care/hospice - CORRECT ANSWER - Medicare Part A
This part of Medicare covers outpatient, home health, durable medical equipment, prosthetics,
and orthotics. Patients are responsible for 20% coinsurance rate under this part of Medicare -
CORRECT ANSWER - Medicare Part B
The following are true about Medicare in Home Health except - CORRECT ANSWER - OTs
can complete the initial evaluation
The following is true about the Therapy Cap Except - CORRECT ANSWER - OT and SLP
are lumped into the same category
Consider that the Utilization Review for fraud and abuse has three levels. The following
describes this level: This review occurs onsite and includes a review of patient documentation
and billing records - CORRECT ANSWER - Level III
This prospective payment system is found with the SNF setting. It pays an all-inclusive amount
based on 8 categories that are measured including rehab plus extensive services, behavior
problems, reduced physical function, rehabilitation, extensive services, special care, clinically
complex, and impaired cognition. This also has been listed as an area of fraudulent action
completed in SNF by Medicare as many clients were placed in Ultra highs when not clinically
appropriate - CORRECT ANSWER - Resource Utilization Group (RUG)
An example of an entitlement program where eligible persons have a guarantee to a defined set
of benefits identified in the law - CORRECT ANSWER - Medicare
, This is a term for economic resources that are transferred from one group to another group to
meet a defined social need - CORRECT ANSWER - Social Insurance
Major Data Sections for the MDS include all of the following except - CORRECT
ANSWER - Income
The Patient Protection and Affordable Care Act (PPACA) of 2010 had this impact on Medicaid -
CORRECT ANSWER - Significantly expanded the coverage of Medicaid
All stated are required to cover those who fit the criteria in one or more categories. The
following populations are eligible for coverage under Medicaid except: - CORRECT
ANSWER - Those with Social Security Income at the Federal Poverty Level
The following is an optional benefit of Medicaid (the rest are mandatory benefits) - CORRECT
ANSWER - Prescription Drugs
This service operates the largest health care system in the US. OTs and PTs are important
members of the team. A minimum of 2 years of service and an honorable discharge from the
military is required - CORRECT ANSWER - Veteran Affairs
This service is an agency of the federal government with health care developed and administered
by tribal self determination. OT and PT may be civilian or commissioned members - CORRECT
ANSWER - Indian Health Service
There are 2 sets of criteria for Medicaid eligibility including categorical eligibility and medically
needy eligibility. One are of categorical eligibility includes income. Income for eligibility for
Medicaid is compared to this to determine eligibility - CORRECT ANSWER - The Federal
Poverty Level (FPL)
This service is for active military personnel and retired military and their families. This service
includes 3 insurance options (prime, extra, and standard). This service mandates rehab coverage
for its participants - CORRECT ANSWER - TRICARE
Questions and CORRECT Answers
The following criteria is required for Medicare services Except - CORRECT ANSWER -
Married and a past contributor to Medicare
This part of medicare covers outpatient, hospital care, short-term skilled nursing facility care,
and home health care/hospice - CORRECT ANSWER - Medicare Part A
This part of Medicare covers outpatient, home health, durable medical equipment, prosthetics,
and orthotics. Patients are responsible for 20% coinsurance rate under this part of Medicare -
CORRECT ANSWER - Medicare Part B
The following are true about Medicare in Home Health except - CORRECT ANSWER - OTs
can complete the initial evaluation
The following is true about the Therapy Cap Except - CORRECT ANSWER - OT and SLP
are lumped into the same category
Consider that the Utilization Review for fraud and abuse has three levels. The following
describes this level: This review occurs onsite and includes a review of patient documentation
and billing records - CORRECT ANSWER - Level III
This prospective payment system is found with the SNF setting. It pays an all-inclusive amount
based on 8 categories that are measured including rehab plus extensive services, behavior
problems, reduced physical function, rehabilitation, extensive services, special care, clinically
complex, and impaired cognition. This also has been listed as an area of fraudulent action
completed in SNF by Medicare as many clients were placed in Ultra highs when not clinically
appropriate - CORRECT ANSWER - Resource Utilization Group (RUG)
An example of an entitlement program where eligible persons have a guarantee to a defined set
of benefits identified in the law - CORRECT ANSWER - Medicare
, This is a term for economic resources that are transferred from one group to another group to
meet a defined social need - CORRECT ANSWER - Social Insurance
Major Data Sections for the MDS include all of the following except - CORRECT
ANSWER - Income
The Patient Protection and Affordable Care Act (PPACA) of 2010 had this impact on Medicaid -
CORRECT ANSWER - Significantly expanded the coverage of Medicaid
All stated are required to cover those who fit the criteria in one or more categories. The
following populations are eligible for coverage under Medicaid except: - CORRECT
ANSWER - Those with Social Security Income at the Federal Poverty Level
The following is an optional benefit of Medicaid (the rest are mandatory benefits) - CORRECT
ANSWER - Prescription Drugs
This service operates the largest health care system in the US. OTs and PTs are important
members of the team. A minimum of 2 years of service and an honorable discharge from the
military is required - CORRECT ANSWER - Veteran Affairs
This service is an agency of the federal government with health care developed and administered
by tribal self determination. OT and PT may be civilian or commissioned members - CORRECT
ANSWER - Indian Health Service
There are 2 sets of criteria for Medicaid eligibility including categorical eligibility and medically
needy eligibility. One are of categorical eligibility includes income. Income for eligibility for
Medicaid is compared to this to determine eligibility - CORRECT ANSWER - The Federal
Poverty Level (FPL)
This service is for active military personnel and retired military and their families. This service
includes 3 insurance options (prime, extra, and standard). This service mandates rehab coverage
for its participants - CORRECT ANSWER - TRICARE
