SMQT- Survey & Certification
Background(Study group for passing
the SMQT exam)2023
Social Security Act of 1965 - Answer It was signed into law by President Johnson on
July 30, 1965. The law established both Medicare, the health insurance program for
Americans over 65 and Medicaid, the health insurance program for low-income
Americans.
Health Care Financing Administration (HCFA) - Answer Created in 1977 to combine,
under one administration, the oversight of Medicare and Medicaid under the HCFA
(the predecessor of CMS).
Medicare - Answer Signed into law in 1965, Medicare is a Health Insurance Program
for the following groups:
- People age 65 or older
- People under age 65 with certain disabilities
- People of all ages with End-Stage Renal Disease (permanent kidney failure
requiring dialysis or a kidney transplant)
Medicaid - Answer Medicaid is a medical assistance program jointly financed by
State and Federal governments for eligible low-income individuals. The program
covers a variety of groups, including the following:
- The needy elderly
- Blind
- Disabled individuals receiving cash assistance under the Supplemental Security
Income Program
- Certain infants and low-income pregnant women
- At the option of the State, other low-income individuals with medical bills that
qualify them as categorically or medically needy.
Medicaid is a state program that provides medical services to clients of the state
public assistance program and, at the State's option, other needy individuals.
Medicaid also augments the hospital and nursing facility (NF) services mandated
under Medicaid.
States may decide on the amount, duration, and scope of additional services, except
that care in institutions primarily for the care and treatment of mental health issues,
may not be included for persons over age 21 and under age 65.
Clinical Laboratory Improvement Amendments (CLIA) - Answer Signed into law in
1988, CLIA regulations include federal standards applicable to all U.S. laboratory
facilities or sites that test human specimens for health assessment or to diagnose,
prevent, or treat disease. The CDC, in partnership with the CMS and FDA, supports
the CLIA program and clinical laboratory quality.
- The Centers for Disease Control & Prevention is responsible for the CLIA studies,
convening the Clinical Laboratory Improvement Amendments Committee (CLIAC) &
provides scientific & technical support to CMS.
, SMQT- Survey & Certification
Background(Study group for passing
the SMQT exam)2023
- A laboratory is defined as any facility that performs laboratory testing on specimens
derived from humans for the purpose of providing information for the diagnosis,
prevention, treatment of disease, or impairment of, or assessment of health.
- CLIA covers approximately 175,000 laboratory entities.
- The Food & Drug Administration (FDA) is responsible for test categorization.
- The Division of Laboratory Services, within the Survey & Certification Group, under
the Center for Medicaid, CHIP and Survey & Certification have the responsibility for
implementing the CLIA Program.
- CMS is charged with the implementation of CLIA, including laboratory registration,
fee collection, certificate generation, surveys, surveyor guidelines development &
training, enforcement, financial management, & finally, approvals of proficiency
testing providers, accrediting organizations & exempt states.
Title XVIII of the Social Security Act - Answer Title XVIII (18) established regulations
for the Medicare program. The Chapter also provides insurance coverage for
hospital, post-hospital, home health services, and hospice care for the aged and
disabled. regardless of income or health status.
Title XIX (Medicaid) of the Act - Answer Title XIX (19) of the Social Security Act
established regulations for the Medicaid program, specifically, the Chapter
appropriates money to States for families with dependent children and for aged,
blind, or disabled individuals, whose income and resources are insufficient to meet
the costs of necessary medical services.
Title XVIII (18) + Title XIX (19) of the Social Security Act - Answer Both titles
mandate the establishment of minimum health and safety standards that must be
met by providers and suppliers participating in the Medicare and Medicaid programs.
42 CFR Part 431.51 - Answer Provides Medicaid recipients with free choice of
providers. On a statutory basis, 42 CFR Part 431.51 provides that beneficiaries may
obtain services from any qualified Medicaid provider that undertakes to provide the
services to them.
PROVIDERS (Medicare Terminology) - Answer In Medicare terminology, providers
are resident care institutions such as hospitals, hospices, nursing homes, and home
health agencies.
SUPPLIERS - Answer Suppliers are agencies for diagnosis and therapy rather than
sustained resident care, such as laboratories, clinics, & physical therapist (PT)
offices.
Background(Study group for passing
the SMQT exam)2023
Social Security Act of 1965 - Answer It was signed into law by President Johnson on
July 30, 1965. The law established both Medicare, the health insurance program for
Americans over 65 and Medicaid, the health insurance program for low-income
Americans.
Health Care Financing Administration (HCFA) - Answer Created in 1977 to combine,
under one administration, the oversight of Medicare and Medicaid under the HCFA
(the predecessor of CMS).
Medicare - Answer Signed into law in 1965, Medicare is a Health Insurance Program
for the following groups:
- People age 65 or older
- People under age 65 with certain disabilities
- People of all ages with End-Stage Renal Disease (permanent kidney failure
requiring dialysis or a kidney transplant)
Medicaid - Answer Medicaid is a medical assistance program jointly financed by
State and Federal governments for eligible low-income individuals. The program
covers a variety of groups, including the following:
- The needy elderly
- Blind
- Disabled individuals receiving cash assistance under the Supplemental Security
Income Program
- Certain infants and low-income pregnant women
- At the option of the State, other low-income individuals with medical bills that
qualify them as categorically or medically needy.
Medicaid is a state program that provides medical services to clients of the state
public assistance program and, at the State's option, other needy individuals.
Medicaid also augments the hospital and nursing facility (NF) services mandated
under Medicaid.
States may decide on the amount, duration, and scope of additional services, except
that care in institutions primarily for the care and treatment of mental health issues,
may not be included for persons over age 21 and under age 65.
Clinical Laboratory Improvement Amendments (CLIA) - Answer Signed into law in
1988, CLIA regulations include federal standards applicable to all U.S. laboratory
facilities or sites that test human specimens for health assessment or to diagnose,
prevent, or treat disease. The CDC, in partnership with the CMS and FDA, supports
the CLIA program and clinical laboratory quality.
- The Centers for Disease Control & Prevention is responsible for the CLIA studies,
convening the Clinical Laboratory Improvement Amendments Committee (CLIAC) &
provides scientific & technical support to CMS.
, SMQT- Survey & Certification
Background(Study group for passing
the SMQT exam)2023
- A laboratory is defined as any facility that performs laboratory testing on specimens
derived from humans for the purpose of providing information for the diagnosis,
prevention, treatment of disease, or impairment of, or assessment of health.
- CLIA covers approximately 175,000 laboratory entities.
- The Food & Drug Administration (FDA) is responsible for test categorization.
- The Division of Laboratory Services, within the Survey & Certification Group, under
the Center for Medicaid, CHIP and Survey & Certification have the responsibility for
implementing the CLIA Program.
- CMS is charged with the implementation of CLIA, including laboratory registration,
fee collection, certificate generation, surveys, surveyor guidelines development &
training, enforcement, financial management, & finally, approvals of proficiency
testing providers, accrediting organizations & exempt states.
Title XVIII of the Social Security Act - Answer Title XVIII (18) established regulations
for the Medicare program. The Chapter also provides insurance coverage for
hospital, post-hospital, home health services, and hospice care for the aged and
disabled. regardless of income or health status.
Title XIX (Medicaid) of the Act - Answer Title XIX (19) of the Social Security Act
established regulations for the Medicaid program, specifically, the Chapter
appropriates money to States for families with dependent children and for aged,
blind, or disabled individuals, whose income and resources are insufficient to meet
the costs of necessary medical services.
Title XVIII (18) + Title XIX (19) of the Social Security Act - Answer Both titles
mandate the establishment of minimum health and safety standards that must be
met by providers and suppliers participating in the Medicare and Medicaid programs.
42 CFR Part 431.51 - Answer Provides Medicaid recipients with free choice of
providers. On a statutory basis, 42 CFR Part 431.51 provides that beneficiaries may
obtain services from any qualified Medicaid provider that undertakes to provide the
services to them.
PROVIDERS (Medicare Terminology) - Answer In Medicare terminology, providers
are resident care institutions such as hospitals, hospices, nursing homes, and home
health agencies.
SUPPLIERS - Answer Suppliers are agencies for diagnosis and therapy rather than
sustained resident care, such as laboratories, clinics, & physical therapist (PT)
offices.
