ACA Quality Assurance & Compliance 3

Question 1

Which ACA provision established the National Strategy for Quality Improvement in Health Care?

Accepted Answer

Section 3011

Answer

ACA Section 3011 required HHS to develop and publish a National Quality Strategy to guide quality improvement across the health care system.

Question 2

A health plan's Medical Loss Ratio (MLR) report must be submitted to CMS by what deadline each year?

Accepted Answer

June 1 following the end of the calendar year

Answer

Issuers must submit annual MLR reports to CMS by June 1 following the end of the MLR reporting year.

Question 3

Under the ACA's quality reporting framework, what is a 'Consumer Assessment of Healthcare Providers and Systems' (CAHPS) survey used to measure?

Accepted Answer

Patient experience with their health plan and care

Answer

CAHPS surveys measure patients' perceptions of their experiences with health plans, providers, and facilities as part of ACA quality reporting.

Question 4

Which ACA program financially penalizes hospitals with excess readmissions within 30 days of discharge?

Accepted Answer

Hospital Readmissions Reduction Program (HRRP)

Answer

The HRRP reduces Medicare payments to hospitals with higher-than-expected 30-day readmission rates for specified conditions.

Question 5

Under ACA quality compliance standards, what is the primary purpose of HEDIS (Healthcare Effectiveness Data and Information Set)?

Accepted Answer

To measure health plan performance on dimensions of care and service

Answer

HEDIS is a widely used tool that allows consumers to compare health plan performance across standardized quality and service measures.

(ACA) Affordable Care Act Certified Practice Test