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1993.10.01 :  Medicaid's Early and Periodic Screening, Diagnostic and Treatment Program

Contact:  Anne Verano (202) 690-6145
October 1, 1993

     HHS Secretary Donna E. Shalala today issued a proposed
regulation to enhance the medical screening, diagnostic and
treatment services available to millions of children under the
age of 21 covered by Medicaid.
     "While the states operate their individual Medicaid programs
within broad federal guidelines, the new rule will require them
to provide any medically necessary service covered under
Medicaid, whether or not the service is already part of a state's
plan," Secretary Shalala said.  "The program's aim is to detect
and treat health problems and illnesses before they worsen and
become more costly."
     Medicaid's Early and Periodic Screening, Diagnostic and
Treatment program requires states to provide screening services,
which include physical exams, immunizations, laboratory tests
including the detection of lead poisoning, and health education. 
In addition, dental, vision and hearing services are required. 
All states are required to establish distinct periodic schedules
for providing each service.
     Secretary Shalala also announced the Health Care Financing
Administration has launched an initiative, involving both the
public and private sectors, to increase participation by children
and providers in Medicaid's comprehensive child health program.
     Participating with HCFA in this effort are the American
Public Welfare Association, the Association of Maternal and Child
Health Directors, the State Medicaid Directors and the Public
Health Service. 
     In FY 1992, the 15.1 million children under the age of 21
covered by Medicaid comprised the largest group among the
program's 31.2 million beneficiaries.  Vendor payments related to
the children amounted to approximately $19.4 billion.
     The new regulation's primary purpose, Secretary Shalala
said, is to codify the existing screening, diagnostic and
treatment policies in the Code of Federal Regulations and to
define such services under Medicaid.
     Under the EPSDT program, state Medicaid agencies are
required to advise eligible individuals under the age of 21, or
their parents or guardians, about the availability of the
screening, diagnostic and treatment services.
     States are required to make requested screening services
available on a timely basis. If the screening services detect a
health problem or illness, any additional medically necessary
diagnostic or treatment services must be provided.
     Comments will be received on the proposed regulation for 60
days after the date of publication in the Federal Register.