Hosam Mohamed-
means tested program; state & federal government; states
Medicaid is a __________ that is funded by ___________ and managed by the ________
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1965; Title XIX of the social security act
Medicaid was enacted in ____ under ___________
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true
The federal government does not require the states to have a medicaid program. T or F?
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FMAP
-the percentage of Medicaid program costs paid by the federal government
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50%; 83%
By law, the FMAP cannot be lower than ______ and higher than _______
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mandated categorically needy, optionally categorically needed, medically needed
What are the 3 broad groups covered by medicaid?
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balance billing
There is no ________ in the Medicaid program.
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CMS
-establishes the broad guidelines that the states use to design and run their individual programs.
-states are afforded some flexibility in determining who qualifies
-medicaid is 56 different programs
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all children up to age 19 in low income families, Pregnant women, elderly & individuals with disabilities who receive SSI
Who is considered Mandated Categorically Needy?
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Optionally Categorically Needy
-determined by states
-does not meet mandated requirements, but share certain characteristics with mandated categorically needy
-must receive same benefits as mandated group
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Medically Needy
-individuals who have too much income to qualify under mandatory or optional group
-persons who spend down by incurring medical expenses so that, after medical expenses, their income falls below a state-established income limit.
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no
Are states required to off Medicaid benefits to "medically needy" individuals?
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statewideness, freedom of choice, comparability of services
What are the 3 general requirements states must adhere to in regards to creating their medicaid programs?
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skilled nursing care
What accounts for the largest % of spending in Medicaid?
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SCHIP
-created and passed as part of the Balanced Budget Act of 1997
-federal/state partnership
-created to provide health insurance to children whose families earn too much to be eligible for Medicaid, but not enough for private insurance.
