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Up to what percentage of the plan's payment schedule are private fee-for-service (PFFS) plans authorized to charge enrollees?

a) 100%
b) 115%
c) 130%
d) 150%

User Sveerap
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1 Answer

2 votes

Final answer:

The correct option is (d), indicating that private fee-for-service (PFFS) plans are authorized to charge enrollees up to 150% of the plan's payment schedule, which aligns with the flexibility of PFFS plans to set higher payment rates.

Step-by-step explanation:

The question pertains to the amount that private fee-for-service (PFFS) plans are allowed to charge enrollees over the plan's payment schedule. According to the information provided, the authorized charge could be less than 100%, exactly 100%, or more than 100% of the plan's payment schedule.

Option (a) suggests it would be 0 percent which is not a viable scenario as it implies no charge over the schedule. Option (b) suggests it would be less than 100 percent which contradicts the nature of PFFS plans as they typically involve charges above the base rate. Option (c) indicates it would be 100 percent, meaning the charge matches the payment schedule exactly with no additional cost. Finally, option (d) suggests a charge greater than 100 percent indicates that enrollees may be charged above the standard rate.

In the context of the information provided, the most accurate option is (d), which states enrollees can be charged up to 150% of the plan's payment schedule. This is because PFFS plans are known to have the flexibility to set their payment rates, which can be above what traditional Medicare would pay.

User Nathan Pitman
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