Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services. The Omnibus Budget Reconciliation Act of 1989 (OBRA 89) mandated that all Medically Necessary services listed in section 1905(a) of the Social Security Act be covered under Medicaid for the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit provided for Medicaid eligible children under the age of twenty-one (21). EPSDT services are included in the prepaid benefit package for children and adolescents up to age twenty-one (21). The federal government, through the Centers for Medicare and Medicaid Services (CMS), requires states to demonstrate an eighty percent (80%) compliance rate for EPSDT screening schedules. MCOs are required to:
1. Provide notification of screening due dates;
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services. The Omnibus Budget Reconciliation Act of 1989 (OBRA 89) mandated that all Medically Necessary services listed in Section 1905(a) of the Social Security Act be covered under Medicaid for the EPSDT benefit provided for Medicaid eligible children under the age of twenty-one (21). EPSDT services include all mandatory and optional Medically Necessary services (including treatment) and items listed in 42 USC 1396d(a) to correct or ameliorate defects, and physical and mental illness and conditions discovered by the HealthCheck screening. EPSDT services are included in the prepaid benefit package for children and adolescents up to age twenty-one (21). The federal government, through the CMS, requires states to demonstrate an eighty percent (80%) compliance rate for EPSDT screening schedules. In West Virginia, EPSDT is called HealthCheck. The MCO is responsible for working with parents, caregivers, and CPS workers to ensure all children and youth covered through this contract receive the EPSDT HealthCheck screenings according to the periodicity schedule or as determined to be medically necessary for the child.
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services. As defined by Sections 1902(a)(43) and 1905(a)(4)(B) and 1905(r) of the Social Security Act and Federal regulations at 42 C.F.R. Part 441 Subpart B and in Mississippi State Plan, Administrative Code, and written communication to the Contractor. The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for EPSDT eligible Members who are enrolled in Medicaid. EPSDT is key to ensuring that children and adolescents receive appropriate preventive, dental, mental health, and developmental, and specialty services.
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services. The Omnibus Budget Reconciliation Act of 1989 (OBRA 89) mandated that all Medically Necessary services listed in section 1905(a) of the Social Security Act be covered under Medicaid for the EPSDT benefit provided for Medicaid eligible children under the age of twenty-one (21). EPSDT services are included in the prepaid benefit package for children and adolescents up to age twenty-one (21). The federal government, through the CMS, requires states to demonstrate an eighty percent (80%) compliance rate for EPSDT screening schedules. In West Virginia, EPSDT is called HealthCheck. The MCO is responsible for working with parents, caregivers, and CPS workers to ensure all children and youth covered through this contract receive the EPSDT HealthCheck screenings according to the periodicity schedule or as determined to be medically necessary for the child.
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services. The Omnibus Budget Reconciliation Act of 1989 (OBRA 89) mandated that all Medically Necessary services listed in section 1905(a) of the Social Security Act be covered under Medicaid for the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit provided for Medicaid eligible children under the age of twenty-one (21). EPSDT services include all mandatory and optional Medically Necessary services (including treatment) and items listed in 42 USC 1396d(a) to correct or ameliorate defects, and physical and mental illness and conditions discovered by the HealthCheck screening. EPSDT services are included in the prepaid benefit package for all enrolled children and adolescents up to age twenty-one (21). EPSDT services shall be provided to WVCHIP enrollees in the same manner as provided to Medicaid enrollees. The federal government, through the Centers for Medicare and Medicaid Services (CMS), requires states to demonstrate an eighty percent (80%) compliance rate for EPSDT screening schedules. The MCO is required to:
1. Provide annual notification to the parents, or custodian of the child, of screening due dates;
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services. The Omnibus Budget Reconciliation Act of 1989 (OBRA 89) mandated that all Medically Necessary services listed in section 1905(a) of the Social Security Act be covered under Medicaid for the EPSDT benefit provided for Medicaid eligible children under the age of twenty-one (21). EPSDT services include all mandatory and optional Medically Necessary services (including treatment) and items listed in 42 USC 1396d(a) to correct or ameliorate defects, and physical and mental illness and conditions discovered by the HealthCheck screening. EPSDT services are included in the prepaid benefit package for all enrolled children and adolescents up to age twenty-one (21). EPSDT services shall be provided to WVCHIP enrollees in the same manner as provided to Medicaid enrollees. The federal government, through CMS, requires states to demonstrate an eighty percent (80%) compliance rate for EPSDT screening schedules. The MCO is required to:
1. Provide annual notification to the parents, or custodian of the child, of screening due dates;
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services. The Omnibus Budget Reconciliation Act of 1989 (OBRA 89) mandated that all Medically Necessary services listed in section 1905(a) of the Social Security Act be covered under Medicaid for the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit provided for Medicaid eligible children under the age of 21. EPSDT services are included in the prepaid benefit package for children and adolescents up to age 21. The federal government, through the Centers for Medicare and Medicaid Services (CMS), requires states to demonstrate an 80 percent compliance rate for EPSDT screening schedules. MCOs are required to:
1. Provide notification of screening due dates;
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services. The Omnibus Budget Reconciliation Act of 1989 (OBRA 89) mandated that all Medically Necessary services listed in section 1905(a) of the Social Security Act be covered under Medicaid for the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit provided for Medicaid eligible children under the age of twenty-one (21). EPSDT services are included in the prepaid benefit package for children and adolescents up to age twenty-one (21). The federal government, through the Centers for Medicare and Medicaid Services (CMS), requires states to demonstrate an eighty (80) percent compliance rate for EPSDT screening schedules. MCOs are required to:
1. Provide notification of screening due dates;
2. Perform the screenings according to the State-determined periodicity schedule;
3. Make the necessary referrals;
4. Track referrals and treatments;
5. Report the results via the encounter reporting system; and
6. Report results as necessary to meet federal requirements, as requested by BMS. MCOs must have written policies and procedures for providing the full range of EPSDT services to all eligible children and young adults up to age twenty-one (21). This information must be available for the hearing- and visually-impaired. Translation services should be made available as necessary. The full scope of EPSDT service requirements is described below.
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services. The Omnibus Budget Reconciliation Act of 1989 (OBRA 89) mandated that all Medically Necessary services listed in section 1905(a) of the Social Security Act be covered under Medicaid for the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit provided for Medicaid eligible children under the age of twenty-one (21). EPSDT services include all mandatory and optional Medically Necessary services (including treatment) and items listed in 42 USC 1396d(a) to correct or ameliorate defects, and physical and mental illness and conditions discovered by the HealthCheck screening. EPSDT services are included in the prepaid benefit package for children and adolescents up to age twenty-one (21). The federal government, through the Centers for Medicare and Medicaid Services (CMS), requires states to demonstrate an eighty percent (80%) compliance rate for EPSDT screening schedules. MCOs are required to:
1. Provide annual notification to the parents, or custodian of the child, of screening due dates;
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services. EPSDT is a federally-mandated preventive health care program designed to improve the overall health of Medicaid-eligible infants, children and adolescents from birth to twenty-one
