Exam (elaborations)
Global Exam #4 (Final) questions with correct answers
- Course
- Institution
Global Exam #4 (Final) questions with correct answers
[Show more]
Content preview
Global Exam #4 (Final)True or False. Because tiered pharmacy benefit designs encourage the use of high-cost drugs, they also
encourage the enrollment of high-risk consumers. - correct answer ✔✔False
True or False. Benefit mandates often generate significant controversy and debate about the balance
between comprehensiveness and the affordability of coverage. - correct answer ✔✔True
True or False. Coverage exclusions are services or products that are never covered by the plan, even
when medically necessary. - correct answer ✔✔True
True or False. Health insurance plans generally cover a comprehensive array of benefits because
purchasing individual benefits piece by piece would lead to substantial adverse selection. - correct
answer ✔✔True
In 1974, what state enacted the Prepaid Health Care Act, which required employers to offer health
insurance to all employees who work over 20 hours per week?
A. Oregon
B. Hawaii
C. Massachusetts
D. California - correct answer ✔✔B
In 2006, what city passed a pair of laws to expand health coverage to its residents and workers?
A. Portland
,B. Boston
C. New York City
D. San Francisco - correct answer ✔✔D
In 2006, what state passed broad legislation expanding healthcare coverage, similar to the ACA, in which
one study found improved credit scores and reduced household debt and personal bankruptcy?
A. Oregon
B. Hawaii
C. Massachusetts
D. California - correct answer ✔✔C
In 2014, a point-in-time estimate for the number of people uninsured is about what percent of the
population?
A. 8 percent
B. 10 percent
C. 12 percent
D. 14 percent - correct answer ✔✔C
True or False. In 2014, as part of the Affordable Care Act, almost all Americans were required to have
health insurance. - correct answer ✔✔True
,In a classic four-tier formulary, the first tier contains the lowest copayment for what type of drugs?
A. Generic drugs
B. Preferred branded drugs
C. Nonpreferred branded drugs
D. Biologics - correct answer ✔✔A
True or False. In an open formulary, drugs not listed may still be covered but at a higher copayment. -
correct answer ✔✔True
True or False. Many private health insurers model their coverage and reimbursement decisions after the
Medicaid program. - correct answer ✔✔False
True or False.
Massachusetts's health reform in 2006 resulted in improved self-reported health for the previously
uninsured. - correct answer ✔✔True
True or False. New plans must offer some preventive services, like routine immunizations, without cost-
sharing. - correct answer ✔✔True
True or False. Over half (54 percent) of the uninsured population work in full-time jobs. - correct answer
✔✔True
True or False. Prior to the ACA, federal law included some benefit mandates, but they applied only to
plans that covered certain services. - correct answer ✔✔True
Referral and prior authorization are two tools used for which of the following purposes?
, A. Care management
B. Risk management
C. Utilization management
D. Medical necessity - correct answer ✔✔C
True or False. Since changes to the Medicare program often influence the benefits that private insurers
offer and the prices they pay, plans are required to align their policies with Medicare. - correct answer
✔✔False
True or False. Since the uninsured do not have as much contact with the medical system, the insured
accrue medical debt and report difficulty paying medical bills more than the uninsured. - correct answer
✔✔True
True or False. The Emergency Treatment and Active Labor Act (EMTALA) restricts hospitals and providers
from billing uninsured consumers for services as well as turning them away from the hospital. - correct
answer ✔✔False
The SCHIP program expands coverage to:
A. low- and middle-income adults who do not qualify for public insurance and who have not been
uninsured for 3 months.
B. employees who work over 20 hours per week and are not offered insurance under their employer.
C. children whose parents' incomes are too high to qualify for Medicaid.
D. disabled individuals without insurance. - correct answer ✔✔C
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Sakayobako30. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $19.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81531 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now