CMS Emergency Procedures & Response 5

Question 1

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?

Accepted Answer

A documented emergency power plan, including backup power source testing policies, as part of their emergency preparedness program

Answer

CMS Conditions of Participation require Medicare-certified long-term care facilities to have documented emergency preparedness programs including backup power policies and testing schedules.

Question 2

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?

Accepted Answer

The beneficiary can seek Medicare Part A or B coverage for the unrelated acute condition while remaining on hospice for the terminal diagnosis

Answer

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.

Question 3

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?

Accepted Answer

The Emergency Medical Treatment and Labor Act (EMTALA)

Answer

EMTALA requires Medicare-participating hospitals with emergency departments to screen and stabilize all patients regardless of insurance status or ability to pay.

Question 4

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?

Accepted Answer

Up to 115% of the Medicare-approved amount if they are a non-participating provider

Answer

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.

Question 5

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?

Accepted Answer

A Medicare-certified hospital providing the service to a patient in a rural Health Professional Shortage Area (HPSA)

Answer

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.

(CMS) Certified Medicare Specialist Practice Test

(CMS) Certified Medicare Specialist Practice Test

CMS Emergency Procedures & Response 5