Exam 2 Review

1. Optional Medicaid service coverage
4. This type of relationship is a characteristic of different managed care models
6. Used by the Federal government to measure the use of hospital services by Medicare patients
7. No Medicaid patient cost sharing for this type of service
9. This type of drug utilization review is done at the time of dispensing
11. Joint State and Federal insurance
13. Federal insurance with standard guidelines across States
16. Medicare Parts B and D, has this for those with higher income
18. Physicians experience this when their practice patterns are compared on cost and quality dimensions
21. Persons with this disease may gain coverage from Medicare if they are younger than 65 years (acronym)
22. Providers are paid a specific amount of money for a population for a specific period
23. CMS calculates this to help determine how much to contribute to each State's Medicaid program (acronym)
24. Eligibility age for Medicare

2. Federal requirement of States to not limit the availability and coverage of services
3. If a managed care plan has few benefit controls, then the cost becomes ___________
5. Medicare does not give extensive coverage for this service
8. Medicare Part B reimburses this group of providers
10. Health plan that has a tax advantage account attached to it
12. This characteristic of a managed care plan refers to the financial risk taken on by a provider
14. This insurance plan will not cover out of network care, if not an emergency (acronym)
15. This type of plan offers Medicare Part C
17. This type of managed Care plan is preferred by patients
19. Access to Medicaid is based on this
20. Medicare part D covers this