C. Implement health care coverage for the working class and needy, in 1915 they introduced a national health insurance bill that was rejected but later the Social Security Act. They were involved in child labor laws, coal mining safety, free employment service, health insurance, occupational diseases, worker's comp etc.
1. By creating a committee on social welfare, the American Association of Labor Legislation helped to A. Decrease public hospital costs. B. Implement fee schedules. C. Implement health care coverage for the working class and needy. D. Create the Indian Health Service. 2. You belong to an HMO. By paying the HMO premium and being treated through that HMO, you’re helping to A. Increase plan enrollment. B. Decrease managed care costs. C. Provide more managed care options for enrollees. D. Control plan costs for everyone. 3. Under major medical insurance, $250 must be paid before the company assumes liability. Who is responsible for paying this $250? A. The policyholder C. The provider B. The insurer D. The third-party payer 4. Which type of medical service reimbursement is the least used today? A. Fee-for-service B. Preferred provider organization C. Health maintenance organization D. Capitation 5. You own a company in a state where state funds aren’t mandated for employee health insurance. What’s one option for providing your employees with health care coverage for work-related injuries? A. Medicaid plans C. Medical savings plans B. Referrals to other network groups D. Self-insurance coverage 6. Low income and categorically needy are both eligibility requirements for A. Medicare. C. CHAMPVA. B. Medicaid. D. TRICARE. 7. You need to speak to someone about additional coverage to Medicare Parts A and B. Which of the following organizations should you contact? A. TRICARE C. CHAMPVA B. Blue Cross and Blue Shield D. Indian Health Service 8. Mary needs Medicaid coverage. Where should she start looking for information to determine her eligibility? A. The local hospital social services department B. Her employer C. The federal government Web site D. The state in which she lives 9. Medicare and Medicaid financial issues put constraints on A. Physician services. C. Public hospitals. B. Critical care centers. D. Outpatient services. 10. Which of the following is an expanded option for participation in private health care plans? A. Medicare Part A C. Medicare Advantage B. Medicare Part B D. Medigap 11. The ability to accurately predict yearly expenses was one reason that large companies decided to A. Offer HMO programs. C. Self-insure their employees. B. Enroll in managed care plans. D. Offer medical spending plans. 12. Which health insurance program is designed to complement the retirement, survivor, and disability insurance enacted under Title II of the Social Security Act? A. Medicare B. Medicaid C. State Children’s Health Insurance Program D. Civilian Health and Medical Program—Veterans Administration 13. You’re a physician who wants to join together with other HMO physicians but not give up your individual practice. The best choice for you may be a/an A. Integrated delivery system. B. Preferred provider organization. C. Independent practice association. D. Primary care physician practice. 14. You started working for a private insurance company before the inception of managed care. You’ve been talking with your co-worker about how different reimbursement was in the past. You commented that before managed care, your employer reimbursed providers on a A. Prospective basis. C. Cash-benefit basis. B. Retrospective, fee-for-service basis. D. Medically needy basis. 15. Your niece may be eligible for health care coverage under the State Children’s Health Insurance Program. Where should your niece first start reviewing eligibility requirements? A. Social services B. Place of employment C. In the state where she resides D. The Centers for Medicare and Medicaid Services Mrs. Jones was admitted to the hospital for the first time this year on September 15. On September 25, she was transferred to a skilled nursing facility where she stayed until October 30. She was discharged from the SNF with home health care and a walker. 16. What reimbursement amount will the hospital receive from Medicare? A. $12,856 C. $16,000 B. $13,648 D. $23,000 17. What’s the total amount the patient owes for the hospital stay? A. $0 C. $1,980 B. $792 D. $16,000 18. How much does the patient owe for the SNF stay? A. $0 C. $1,485 B. $99 D. $2,300 19. How much does the patient owe for home health care? A. $0 C. $2,500 B. $500 D. $7,000 20. What’s the total amount that Medicare will pay for the home health care? A. $2,000 C. $7,000 B. $2,500 D. $9,000
