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State Medicaid Agency required activities -- - States must inform all Medicaid-eligible persons under age 21 that EPSDT services as described in section 1905(r) are available and the need for age-appropriate immunizations;
- States must provide or arrange for the provision of such screening services in all cases there they are requested;
- State must arrange (directly or through referral) for corrective treatment the need for which is disclosed by such child health screenings; and
- States must report EPSDT performance information annually (CMS Form-416). The authority for requiring States to submit the annual report is section 1902(a)(43) of the Social Security Act (the Act). Each State must report annually for each Federal fiscal year if they administer or supervise the administration of an approved plan for a Federally aided title XIX program.
The Annual EPSDT report (Form CMS-416) The CMS-416 provides basic information on participation in the Medicaid child health program. The statute requires that States provide us with the following: (1) the number of children provided child health screening services, (2) the number of children referred for corrective treatment, (3) the number of children receiving dental services, and (4) the State's results in attaining goals set for the state under section 1905(r) of the Act. The form CMS-416 was developed to collect this information. The information is used to assess the effectiveness of State EPSDT programs in terms of the number of children (by age group and basis of Medicaid eligibility), who are provided child health screening services, are referred for corrective treatment, and the number receiving dental services. Child health screening services are defined for purposes of reporting on this form as initial or periodic screens required to be provided according to a State's screening periodicity schedule. EPSDT CMS-Form-416 published national data is now available through this web site! See downloads below.
Page Last Modified: 12/10/2008 6:27:17 PM
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