Ch 8: True and False

Question 1

T/F: Medicaid benefits are the same from state to state

Answer 1

False

Question 2

T/F: All states have a Medicaid program

Answer 2

True

Question 3

T/F: In 1972, federal law established the Supplemental Security Income (SSI) program, which provides federally funded cash assistance to unmarried pregnant women with dependent children

Answer 3

False

Question 4

T/F: To be eligible for SSI, an individual must be at least 65 years old, blind, or disabled and must have limited resources

Answer 4

True

Question 5

T/F: All states must cover the cost of prescription drugs for all categories of Medicaid recipients

Answer 5

False

Question 6

T/F: In most states, SSI beneficiaries also can get medical assistance (Medicaid) to pay for hospital stays, doctor bills, prescription drugs, and other health costs

Answer 6

True

Question 7

T/F: People who are eligible for SSI are not entitled to receive Social Security benefits

Answer 7

False

Question 8

T/F: Eligibility for SSI benefits is based on an individual’s employment record

Answer 8

False

Question 9

T/F: States must cover categorically needy individuals, but they have options as to how to define “categorically needy.”

Answer 9

True

Question 10

T/F: To be eligible for the PACE program, individuals must be 65 or older

Answer 10

False

Question 11

T/F: Providers are never allowed to ask a Medicaid-eligible patient to make a copayment

Answer 11

False

Question 12

T/F: Medicaid is allowed to impose cost-sharing charges and premiums on certain categories of Medicaid recipients

Answer 12

True

Question 13

T/F: States cannot establish different copayment schedules for generic versus brand-name drugs

Answer 13

False

Question 14

T/F: States have the option to charge higher copayments for people who visit a hospital emergency department for treatment of a non-emergency

Answer 14

True

Question 15

T/F: All healthcare providers must accept and treat some categories of Medicaid patients

Answer 15

False

Question 16

T/F: Healthcare providers have a choice whether or not to treat Medicaid patients

Answer 16

True

Question 17

T/F: Providers must agree to accept what Medicaid pays as payment in full for covered services and are prohibited by law to “balance bill”

Answer 17

True

Question 18

T/F: With a point-of-sale device, the patient is issued an ID card that is similar in size and design to a credit card

Answer 18

True

Question 19

T/F: Medicaid rarely pays all of the cost-sharing portions (deductibles and coinsurance) of Medicare Part A and B for dually eligible beneficiaries

Answer 19

False

Question 20

T/F: Medicaid is always the “payer of last resort”

Answer 20

True

Question 21

T/F: Both federal and state governments discourage managed healthcare as an option for Medicaid benefits

Answer 21

False

Question 22

T/F: The time limit for filing Medicaid claims in all states is 1 year

Answer 22

False

Question 23

T/F: Assignment should be accepted on all Medicaid claims

Answer 23

True

Question 24

T/F: Prior approval may be required for certain categories of Medicaid services

Answer 24

True

Question 25

T/F: Fraud typically involves payment for items or services in which there was no intent to deceive or misrepresent

Answer 25

False