Emergency Procedures & Response Flashcards
7 cards from real CMS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Emergency Procedures & Response flashcards as text
A long-term care facility's generator fails during a power outage, threatening residents on powered medical equipment. Under CMS emergency preparedness Conditions of Participation, what must the facility have in place?
Answer: A documented emergency power plan, including backup power source testing policies, as part of their emergency preparedness program
CMS Conditions of Participation require Medicare-certified long-term care facilities to have documented emergency preparedness programs including backup power policies and testing schedules.
A Medicare beneficiary who is a hospice patient develops a sudden, unexpected acute condition unrelated to their terminal diagnosis. How should this scenario be handled under Medicare hospice rules?
Answer: The beneficiary can seek Medicare Part A or B coverage for the unrelated acute condition while remaining on hospice for the terminal diagnosis
Hospice patients can receive Medicare coverage for conditions unrelated to their terminal diagnosis through Part A or B while continuing hospice benefits for the terminal illness.
Which federal law requires hospital emergency departments that accept Medicare to provide medical screening examinations and stabilizing treatment to all patients, regardless of their ability to pay?
Answer: The Emergency Medical Treatment and Labor Act (EMTALA)
EMTALA requires Medicare-participating hospitals with emergency departments to screen and stabilize all patients regardless of insurance status or ability to pay.
A Medicare beneficiary undergoes emergency surgery and the surgeon is not enrolled in Medicare. The surgeon bills the patient directly. What is the maximum amount the surgeon can legally charge?
Answer: Up to 115% of the Medicare-approved amount if they are a non-participating provider
Non-participating providers who are not opted out of Medicare are subject to the limiting charge, which caps billing at 115% of the non-participating Medicare fee schedule amount.
During a declared public health emergency, CMS allows telehealth services to be provided from the patient's home. Under normal (non-emergency) Medicare rules, which of the following is an approved distant site for telehealth?
Answer: A Medicare-certified hospital providing the service to a patient in a rural Health Professional Shortage Area (HPSA)
Under traditional Medicare telehealth rules, the patient must be in a rural HPSA or shortage area, and the distant site must be a Medicare-covered facility.
A CMS specialist is helping a beneficiary understand their rights after a hospital issues a discharge notice during an inpatient stay they believe is premature. What should the specialist advise the beneficiary to do first?
Answer: Request an immediate review by the Quality Improvement Organization (QIO) before leaving the hospital
Beneficiaries who disagree with a hospital discharge decision must contact the local QIO before leaving to trigger an immediate review and protect their right to remain without financial liability during the appeal.
A Medicare beneficiary suffered an injury in an automobile accident covered by the patient's auto insurance. Which payer is primary under Medicare Secondary Payer (MSP) rules?
Answer: The automobile insurance (or no-fault insurer) is primary and Medicare is secondary
Under MSP rules, automobile liability and no-fault insurance are primary payers, and Medicare only pays secondary after the primary insurer's liability is exhausted.