Managed Care Test 3 UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS
What marketing and sales activities are not allowed for Medicare Advantage or managed
Medicaid plans: - CORRECT ANSWER Using a purchased list of email addresses or
other types of lists to contact non-members; Door-to-door solicitation or leaflet distribution;
Completing any portion of the enrollment application for a prospective ¬enrollee; Requesting
any beneficiary identification numbers such as their Social Security number, or their personal
contact information
Dual Eligible Special Needs Plans enroll individuals who are "dual eligible." Who are the
"dual eligible"? - CORRECT ANSWER Individuals who are eligible for Medicare and
Medicaid
Plans can receive bonus payments for high star quality ratings. The bonus payments can be
used to: - CORRECT ANSWER Provide additional benefits, Reduce cost sharing,
Reduce enrollee premiums
MA plans must have a quality improvement program that measures performance under the
program and that includes: - CORRECT ANSWER Chronic Care Improvement
Programs (CCIP), Quality Improvement Projects (QIPs), Health Information Systems
Which of the following is not a measure in the Medicare Quality Bonus Program (i.e. the
"Stars" program) for Medicare Advantage plans: - CORRECT ANSWER Reducing
costs
T/f. Most commercial managed care organizations avoid Medicaid because the payment rates
are so low - CORRECT ANSWER False
T/f. Under the ACA, each state has expanded their Medicaid eligibility criteria. - CORRECT
ANSWER False
T/f. CMS requires MA plans to have a quality improvement program to measure program
performance. - CORRECT ANSWER True
QUESTIONS AND CORRECT ANSWERS
What marketing and sales activities are not allowed for Medicare Advantage or managed
Medicaid plans: - CORRECT ANSWER Using a purchased list of email addresses or
other types of lists to contact non-members; Door-to-door solicitation or leaflet distribution;
Completing any portion of the enrollment application for a prospective ¬enrollee; Requesting
any beneficiary identification numbers such as their Social Security number, or their personal
contact information
Dual Eligible Special Needs Plans enroll individuals who are "dual eligible." Who are the
"dual eligible"? - CORRECT ANSWER Individuals who are eligible for Medicare and
Medicaid
Plans can receive bonus payments for high star quality ratings. The bonus payments can be
used to: - CORRECT ANSWER Provide additional benefits, Reduce cost sharing,
Reduce enrollee premiums
MA plans must have a quality improvement program that measures performance under the
program and that includes: - CORRECT ANSWER Chronic Care Improvement
Programs (CCIP), Quality Improvement Projects (QIPs), Health Information Systems
Which of the following is not a measure in the Medicare Quality Bonus Program (i.e. the
"Stars" program) for Medicare Advantage plans: - CORRECT ANSWER Reducing
costs
T/f. Most commercial managed care organizations avoid Medicaid because the payment rates
are so low - CORRECT ANSWER False
T/f. Under the ACA, each state has expanded their Medicaid eligibility criteria. - CORRECT
ANSWER False
T/f. CMS requires MA plans to have a quality improvement program to measure program
performance. - CORRECT ANSWER True
