24 Questions
What is the purpose of Individual Budget Authorizations in Medicaid/MCO programs?
To promote independence and reduce human reliance by providing members with control over their Medicaid/MCO funds for hiring attendants and purchasing goods & services.
What types of services are typically included in Individual Budget Authorizations?
Services that are self-directed and basic non-medical assistance with bathing, dressing, and grooming.
What is Self-Direction in Medicaid/MCO programs?
A program that allows individuals to select whom they wish to provide basic, non-medical assistance.
What is the difference between Traditional Model (Agency) home health and Self-Direction in Medicaid/MCO programs?
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.
How are Financial Management Services Providers selected in Self-Direction programs?
Through a bidding process.
How are Financial Management Services funded in Self-Direction programs?
Financial Management Services are funded by the state as an administrative cost.
What are the risks associated with Self-Direction in Medicaid/MCO programs?
Inability to stay within the allotted budget, misuse of funds, and not following program rules.
What is the role of the Financial Management Services provider in Self-Direction programs?
To manage members' Medicaid/MCO funds and assist with payroll and tax filings for care givers.
How do Managed Care Organizations (MCOs) implement Self-Direction programs?
MCOs contract with Financial Management Services providers to manage members' Medicaid/MCO funds.
What is the training requirement for care givers in Self-Direction programs?
40 hours of intensive required training are required.
What types of technological advancements have been made in Financial Management Services for Self-Direction programs?
Both B and C.
What percentage of elderly members have designated an Authorized Representative in Medicaid/MCO programs?
40%
What is the purpose of Individual Budget Authorizations in Medicaid/MCO programs?
To provide consistent and equitable control of Medicaid/MCO funds for members to hire attendants and purchase goods & services
What is self-direction in Medicaid/MCO programs?
The ability for individuals to select whom they wish to provide basic, non-medical assistance with bathing, dressing and grooming
What is the Traditional Model (Agency) home health in Medicaid/MCO programs?
A model where personal care agencies provide home health services
What is a risk of Self-Direction in Medicaid/MCO programs?
Not completely understanding program rules and responsibilities resulting in misuse of funds or not following program rules
What is the role of Financial Management Services Providers in Medicaid/MCO programs?
To manage the finances of participants in the self-direction program
What is a risk of Self-Direction in Medicaid/MCO programs related to the Provider?
The Provider not performing the work required, completing inadequate work or Providers not showing up
What is the responsibility of the FMS in Medicaid/MCO programs?
To manage the finances of participants in the self-direction program
What is the purpose of the competitive bidding process for Financial Management Services Providers in Medicaid/MCO programs?
To select the best FMS provider for the self-direction program at the lowest possible cost
What is a risk of Self-Direction in Medicaid/MCO programs related to the Participant or Member?
Neglect/self-neglect
What is the role of managed care organizations (MCOs) in implementing self-direction programs in Medicaid/MCO programs?
To contract directly with the FMS provider
What is the percentage of elderly who have designated an Authorized Representative in Medicaid/MCO programs?
40%
What is the trend in the Medicaid and Managed Care markets related to self-direction?
Self-direction is growing in popularity
Test your knowledge on Individual Budget Authorizations with this informative quiz. Learn about the amount of Medicaid/MCO funds under member control and how they can be used to promote independence. Get familiar with the consistent and equitable determination of budgets across all members. Discover the typical costs of services covered by Individual Budget Authorizations. Take this quiz and enhance your understanding of this crucial aspect of Medicaid/MCO programs.
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