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Medical Management

Last Update May 12, 2024
Total Questions : 163

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Medical Management Questions and Answers

Questions 1

CMS has developed two prototype programs—Programs of All-inclusive Care for the Elderly (PACE) and the Social Health Maintenance Organization (SHMO) demonstration project—to deliver healthcare services to Medicare beneficiaries. From the answer choices below, select the response that correctly identifies the features of these programs.

Options:

A.

PACE-annual limits on benefits for nursing home and community-based care SHMO-no limits on long-term care benefits

B.

PACE-provide long-term care only SHMO-provide acute and long-term care

C.

PACE-enrollees must be age 65 or older SHMO-enrollees must be age 55 or older

D.

PACE-enrollment open to nursing home certifiable Medicare beneficiaries only SHMO-enrollment open to all Medicare beneficiaries

Questions 2

DUR can be conducted prospectively, concurrently, or retrospectively. One true statement about prospective DUR is that it

Options:

A.

involves periodic audits of the medical records of a certain group of patients

B.

is based on historical data

C.

focuses on the drug therapy for a single patient rather than overall usage patterns

D.

is conducted by physicians, without input from pharmacists

Questions 3

Demetrius Farrell, age 82, is suffering from a terminal illness and has consulted his health plan about the care options available to him. In order to avoid unwanted, futile interventions, Mr. Farrell signed an advance directive that indicates the types of end-of-life medical treatment he wants to receive. His family is to use this document as a guide should Mr. Farrell become incapacitated.

The document that Mr. Farrell is using to communicate his end-of-life healthcare wishes to his family is known as a

Options:

A.

medical power of attorney

B.

patient assessment and care plan

C.

living will

D.

healthcare proxy

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