CES Medicaid and CHIP Programs 3

Question 1

Which program allows states to use eligibility findings from other programs (like SNAP or TANF) to fast-track Medicaid/CHIP enrollment?

Accepted Answer

Express Lane Eligibility (ELE)

Answer

Express Lane Eligibility lets states use findings from other benefit programs to streamline and accelerate Medicaid and CHIP enrollment determinations.

Question 2

When a child who would otherwise qualify for CHIP has access to employer-sponsored insurance, what is the name of the option that allows CHIP to pay the employee's share of premiums?

Accepted Answer

CHIP Premium Assistance

Answer

CHIP Premium Assistance (also called 'wrap-around' coverage) allows CHIP to pay employer-sponsored insurance premiums when that coverage is cost-effective for the state.

Question 3

Under Medicaid managed care, states contract with health plans to deliver services. What is the most common type of Medicaid managed care arrangement?

Accepted Answer

Comprehensive Risk-Based Managed Care (Capitated MCO)

Answer

Capitated MCOs (Managed Care Organizations) are the dominant form of Medicaid managed care, where states pay a fixed per-member-per-month rate for comprehensive services.

Question 4

What is the CHIP Reauthorization Act of 2009 (CHIPRA) most known for?

Accepted Answer

Expanding CHIP coverage, improving quality, and increasing outreach to eligible children

Answer

CHIPRA reauthorized and expanded CHIP, adding funds, improving quality measures, extending coverage to lawfully residing immigrant children, and boosting outreach efforts.

Question 5

Which of the following individuals is EXEMPT from the ACA's MAGI-based Medicaid income rules?

Accepted Answer

An elderly individual applying for long-term care Medicaid

Answer

Elderly and disabled individuals applying for long-term services and certain Medicare Savings Programs still use the older SSI-based income and asset rules, not MAGI.

CES - Certified Enrollment Specialist Practice Test

CES - Certified Enrollment Specialist Practice Test

CES Medicaid and CHIP Programs 3