Claims Preparations II Medicaid

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Week Three Coursework-HCR 230 Claims Preparations II Medicaid • Describe Medicaid eligibility and coverage. • Explain how Medicaid covered charges are determined. • Discuss effects of the Welfare Reform Act on Medicaid eligibility. ASSIGNMENTS 1. Read Ch. 11 of Medical Insurance. 2. Checkpoint: Working with Medicaid • Resources: Ch. 11 (pp. 374-375, 385-386) of Medical Insurance and the U.S. Department of Health & Human Services Web site. • Due Date: Day 4 (THURSDAY) [to the Assignment Folder] • Refer to U.S. Department of Health & Human Services Web site at • Select Medicaid Program – General Information. • Post a 250- to 300-word response to the following: o Briefly discuss factors that determine Medicaid eligibility, and whether a procedure or service is covered. o When can a provider bill a Medicaid patient directly for services? o What are the implications of simultaneous federal and state involvement in the insurance process? 3. Assignment: The Welfare Reform Act • Due Date: Day 4 (THURSDAY) [to the Assignment Folder] • Write a 750- to 1,050-word paper discussing the positive and negative implications of the Welfare Reform Act of 1996 on Medicaid. Respond to one or more of the following questions in your paper: o Did the Welfare Reform Act cause existing Medicaid beneficiaries to lose necessary coverage? o Do eligible Medicaid candidates sometimes remain un-enrolled even though they are needy as a result of the Welfare Reform Act? o Is the Welfare Reform Act effective in reducing welfare fraud and increasing personal responsibility? o Has the Welfare Reform Act been successful in meeting its intended goals? • Include a minimum of two references from the Internet or University Library. • Format your paper according to APA guidelines. •

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