How Much Do You Know About Individual Budget Authorizations in Medicaid/MCO Prog...
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What is the purpose of Individual Budget Authorizations in Medicaid/MCO programs?

  • To limit the amount of funds available to members for hiring attendants and purchasing goods & services.
  • To provide members with access to Traditional Model (Agency) home health services.
  • To promote independence and reduce human reliance by providing members with control over their Medicaid/MCO funds for hiring attendants and purchasing goods & services. (correct)
  • To ensure equitable distribution of Medicaid/MCO funds across all members.

    • What types of services are typically included in Individual Budget Authorizations?

  • Only self-directed services.
  • Only medical services.
  • Services that are self-directed and advanced medical assistance.
  • Services that are self-directed and basic non-medical assistance with bathing, dressing, and grooming. (correct)

    • What is Self-Direction in Medicaid/MCO programs?

  • A program that limits members' control over their Medicaid/MCO funds.
  • A program that allows individuals to select whom they wish to provide basic, non-medical assistance. (correct)
  • A program that provides members with access to Traditional Model (Agency) home health services.
  • A program that provides advanced medical assistance to members.

    • What is the difference between Traditional Model (Agency) home health and Self-Direction in Medicaid/MCO programs?

    <p>Traditional Model (Agency) home health is provided by personal care agencies while Self-Direction allows individuals to select whom they wish to provide basic, non-medical assistance.</p> Signup and view all the answers

    How are Financial Management Services Providers selected in Self-Direction programs?

    <p>Through a bidding process.</p> Signup and view all the answers

    How are Financial Management Services funded in Self-Direction programs?

    <p>Financial Management Services are funded by the state as an administrative cost.</p> Signup and view all the answers

    What are the risks associated with Self-Direction in Medicaid/MCO programs?

    <p>Inability to stay within the allotted budget, misuse of funds, and not following program rules.</p> Signup and view all the answers

    What is the role of the Financial Management Services provider in Self-Direction programs?

    <p>To manage members' Medicaid/MCO funds and assist with payroll and tax filings for care givers.</p> Signup and view all the answers

    How do Managed Care Organizations (MCOs) implement Self-Direction programs?

    <p>MCOs contract with Financial Management Services providers to manage members' Medicaid/MCO funds.</p> Signup and view all the answers

    What is the training requirement for care givers in Self-Direction programs?

    <p>40 hours of intensive required training are required.</p> Signup and view all the answers

    What types of technological advancements have been made in Financial Management Services for Self-Direction programs?

    <p>Both B and C.</p> Signup and view all the answers

    What percentage of elderly members have designated an Authorized Representative in Medicaid/MCO programs?

    <p>40%</p> Signup and view all the answers

    What is the purpose of Individual Budget Authorizations in Medicaid/MCO programs?

    <p>To provide consistent and equitable control of Medicaid/MCO funds for members to hire attendants and purchase goods &amp; services</p> Signup and view all the answers

    What is self-direction in Medicaid/MCO programs?

    <p>The ability for individuals to select whom they wish to provide basic, non-medical assistance with bathing, dressing and grooming</p> Signup and view all the answers

    What is the Traditional Model (Agency) home health in Medicaid/MCO programs?

    <p>A model where personal care agencies provide home health services</p> Signup and view all the answers

    What is a risk of Self-Direction in Medicaid/MCO programs?

    <p>Not completely understanding program rules and responsibilities resulting in misuse of funds or not following program rules</p> Signup and view all the answers

    What is the role of Financial Management Services Providers in Medicaid/MCO programs?

    <p>To manage the finances of participants in the self-direction program</p> Signup and view all the answers

    What is a risk of Self-Direction in Medicaid/MCO programs related to the Provider?

    <p>The Provider not performing the work required, completing inadequate work or Providers not showing up</p> Signup and view all the answers

    What is the responsibility of the FMS in Medicaid/MCO programs?

    <p>To manage the finances of participants in the self-direction program</p> Signup and view all the answers

    What is the purpose of the competitive bidding process for Financial Management Services Providers in Medicaid/MCO programs?

    <p>To select the best FMS provider for the self-direction program at the lowest possible cost</p> Signup and view all the answers

    What is a risk of Self-Direction in Medicaid/MCO programs related to the Participant or Member?

    <p>Neglect/self-neglect</p> Signup and view all the answers

    What is the role of managed care organizations (MCOs) in implementing self-direction programs in Medicaid/MCO programs?

    <p>To contract directly with the FMS provider</p> Signup and view all the answers

    What is the percentage of elderly who have designated an Authorized Representative in Medicaid/MCO programs?

    <p>40%</p> Signup and view all the answers

    What is the trend in the Medicaid and Managed Care markets related to self-direction?

    <p>Self-direction is growing in popularity</p> Signup and view all the answers

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