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The
Early Periodic Screening, Diagnosis, and
Treatment (EPSDT) Program is
the child health component of Medicaid.
It's
required in every state and is designed
to improve the health of low-income children,
by financing appropriate and necessary pediatric
services. This website provides information
about how EPSDT works with public health,
families, managed care organizations, pediatricians,
and other health providers.
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State
Title V Agencies
Roles in EPSDT Programs |
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Tools
for
MCH Programs |
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Supporting
a Child Health
System Using EPSDT |
State Title V agencies can play an important
role in fulfilling the potential of EPSDT.
Federal rules encourage partnerships between
State Medicaid and Title V agencies to assure
better access to and receipt of the full
range of screening, diagnostic, and treatment
services. States’ experiences show
how collaboration can improve access and
administrative efficiency.
More on EPSDT and
Title V
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Local health care systems vary greatly,
based on provider supply, public health
structures, health coverage patterns,
and State laws. Increasing the efficacy
of linkages between pediatric providers
and other child serving entities is one
key step toward improving care and services
for families.
More on System
of Care Issues |
EPSDT
Pediatric
Benefits |
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Managed
Care
Specifications |
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Evolving
EPSDT
Policy |
EPSDT is designed to address physical,
mental, and developmental health needs.
Screening services “to detect physical
and mental conditions” must be covered
at periodic intervals and when, as well
as diagnostic and treatment coverage.
More
on EPSDT Benefits
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Millions are enrolled with managed
care organizations (MCOs) operating under
contracts with Medicaid. The George Washington
University’s (GWU) Managed Care
Purchasing Specifications offer sample
language that can be used by states, MCOs,
and family advocates to enhance Medicaid
managed care contract language and improve
child health services.
More
on Managed Care and EPSDT |
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For over 35 years, EPSDT has evolved.
As Medicaid changed (e.g, use of managed
care), States clarified EPSDT rules. Congressional
and court actions have also had an effect
on the program. It adapted to changing
pediatric guidelines. The program’s
purpose is “to discover, as early
as possible,” and provide “continuing
follow up and treatment so that handicaps
do not go neglected.”
More
about EPSDT Policy
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