Child and Teen Checkups. The MCO agrees to provide, or arrange to provide Child and Teen Checkups (C&TC) screenings to each Enrollee under age twenty-one (21), as follows, and shall be subject to 42 U.S.C. § 1396d(r):
(A) Pursuant to 42 CFR § 441.56 and the State Medicaid Manual (SMM; CMS-Pub. 45.5) 5122-5123.2, the following C&TC components are currently required and must be performed in accordance with C&TC program standards and according to the periodicity schedule as specified in the current C&TC Chapter of the Provider Manual, which is herein incorporated by reference and made a part of the Contract, as applicable:
(1) Assessment of physical growth.
(2) Vision screening.
(3) Hearing screening.
(4) Health history.
(5) Developmental and behavioral assessment.
(6) Physical examination.
(7) Nutritional assessment.
(8) Immunization and review.
(9) Laboratory tests.
(10) Health education and anticipatory guidance.
(11) The MCO agrees to provide, or arrange to provide, dental services according to the C&TC dental periodicity schedule to each Enrollee from age one (1) to age twenty-one (21).
(B) In order for the MCO to have an encounter considered countable as a C&TC screening, the MCO must provide all components of the C&TC program in the Enrollee’s screening and must be made according to the age-related periodicity schedule.
(C) The MCO must:
(1) Notify Enrollees under the age of twenty-one (21) of the availability of C&TC screening at least annually;
(2) Provide and document all of the required screening components according to the C&TC standards and current periodicity schedule (although the MCO may offer additional preventive services beyond these minimal standards); and
(3) Provide all Medically Necessary health care, diagnostic services, treatments and other measures, to correct or ameliorate defects and physical and mental illnesses and conditions discovered by the screening services, which are mandatory or optional Medical Assistance-covered services under 42 U.S.C. § 1396d(a). See 42 U.S.C. § 1396d(r)(5). Diagnostic services include up to three maternal depression screenings that occur during a pediatric visit for a child under age one. The STATE recommends the initial maternal screening within the first month after delivery, with a subsequent screen suggested at the four month visit.
(D) The STATE agrees to arrange for C&TC training and consultation, in cooperation with the MCO, on the screening components, screening standards, age-related periodicity schedule, reporting r...
Child and Teen Checkups. The MCO agrees to provide, or arrange to provide, Child and Teen Checkup (C&TC) screenings to each Enrollee under age twenty-one (21). [42 USC §1396d(r)]
6.1.6.1 Specific C&TC components are required and must be performed in accordance with C&TC program standards and according to the periodicity schedule as specified in the current C&TC Chapter of the Provider Manual. [42 CFR §441.56 through 441.62]
6.1.6.2 In order for the MCO to have an encounter considered countable as a C&TC screening, the MCO must provide all components of the C&TC program in the Enrollee’s screening according to the age-related periodicity schedule, as above. A C&TC visit is not considered complete unless it includes a HIPAA-compliant referral code which must be included on the encounter claim.
Child and Teen Checkups. The MCO agrees to provide, or arrange to provide Child and Teen Checkups (C&TC) screenings to each Enrollee under age twenty-one (21), as follows, and shall be subject to 42 U.S.C. § 1396d(r):
(A) Pursuant to 42 CFR § 441.56 and the State Medicaid Manual (SMM; CMS- Pub. 45.5) 5122-5123.2, the following C&TC components are currently required and must be performed in accordance with C&TC program standards and according to the periodicity schedule as specified in the current C&TC Chapter of the Provider Manual, which is herein incorporated by reference and made a part of the Contract, as applicable:
(1) Assessment of physical growth.
(2) Vision screening.
(3) Hearing screening.
(4) Health history.
(5) Developmental and behavioral assessment.
(6) Physical examination.
(7) Nutritional assessment.
(8) Immunization and review.
(9) Laboratory tests.
(10) Health education and anticipatory guidance.
(11) The MCO agrees to provide, or arrange to provide, dental services according to the C&TC dental periodicity schedule to each Enrollee from age one (1) to age twenty-one (21).
(B) The STATE shall use encounter data in reporting the MCO’s participation rate to CMS. In order for the MCO to have an encounter considered countable as a C&TC screening for the purpose of reporting the MCO’s participation rate to CMS, the MCO must provide all components of the C&TC program in the Enrollee’s screening and must be made according to the age-related periodicity schedule.
(C) The MCO must:
(1) Notify Enrollees under the age of twenty-one (21) of the availability of C&TC screening at least annually;
(2) Provide and document all of the required screening components according to the C&TC standards and current periodicity schedule (although the MCO may offer additional preventive services beyond these minimal standards); and
(3) Provide all Medically Necessary health care, diagnostic services, treatments and other measures, to correct or ameliorate defects and physical and mental illnesses and conditions discovered by the screening services, which are mandatory or optional Medical Assistance-covered services under 42 U.S.C. § 1396d(a). See 42 U.S.C. § 1396d(r)(5). Diagnostic services include up to three maternal depression screenings that occur during a pediatric visit for a child under age one. The STATE recommends the initial maternal screening within the first month after delivery, with a subsequent screen suggested at the four month visit.
(D) The STATE agrees to arrange for C&TC ...
Child and Teen Checkups. The MCO agrees to provide, or arrange to provide Child and Teen Checkup (C&TC) screenings to each Enrollee under age twenty-one (21), as follows, and shall be subject to 42 USC § 1396d(r):
