Medicaid and CHIP Programs Flashcards
7 cards from real CES practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Medicaid and CHIP Programs flashcards as text
What is the Federal Medical Assistance Percentage (FMAP) used to determine?
Answer: The share of Medicaid costs the federal government reimburses to each state
FMAP is the formula-driven percentage of state Medicaid expenditures that the federal government matches, varying by state based on per capita income.
Which of the following is a mandatory Medicaid service that all states must cover?
Answer: Inpatient hospital services
Inpatient hospital services are a mandatory Medicaid benefit all states must provide, while adult dental, vision, and chiropractic services are optional.
What is 'presumptive eligibility' in the context of Medicaid and CHIP?
Answer: A qualified entity temporarily enrolls an applicant who appears eligible while the formal application is processed
Presumptive eligibility allows trained qualified entities to provide temporary Medicaid/CHIP coverage while the state agency completes the full eligibility determination.
What is the Medicaid Estate Recovery Program (MERP) designed to do?
Answer: Recover Medicaid costs from the estates of deceased beneficiaries who were 55 or older
MERP requires states to seek repayment of Medicaid costs from the estates of deceased beneficiaries who were age 55 or older when they received services.
Under Medicaid rules, retroactive coverage can go back up to how many months prior to the month of application?
Answer: 3 months
Medicaid may cover eligible medical expenses incurred up to 3 months before the month an individual applies, provided they were eligible during those months.
Most lawfully present immigrants must wait how long before becoming eligible for federally funded Medicaid benefits?
Answer: 5 years
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 imposed a 5-year bar on most lawfully present immigrants for federally funded Medicaid.
Which Medicaid waiver authority allows states to test innovative service delivery and financing models that deviate from standard Medicaid rules?
Answer: Section 1115 Demonstration Waiver
Section 1115 Research and Demonstration Waivers give states broad flexibility to pilot approaches that deviate from standard Medicaid requirements, subject to HHS approval.