EPSDT Services. The PH-MCO must comply with the requirements regarding EPSDT services as set forth in Exhibit J, EPSDT Guidelines. The PH-MCO must also adhere to specific Department regulations at 55 Pa. Code Chapters 3700 and 3800 as they relate to EPSDT examination for individuals under the age of 21 and entering substitute care or a child residential facility placement.
EPSDT Services. The Contractor shall comply with 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 that require EPSDT services to include outreach and informing, screening, tracking, and, diagnostic and treatment services. The Contractor must have written policies and procedures, approved by the Division, related to the provision of the full range of EPSDT services as defined in, and in accordance with, the Division's policies and procedures for EPSDT and the provisions of this Contract. Such services shall include, without limitation, periodic health screenings and appropriate and up- to-date immunizations using the ACIP Recommended Immunization Schedule and AAP Bright Futures of all EPSDT eligible Members, in accordance with the Periodicity Schedule established by the Division for EPSDT services, including periodic examinations for vision, dental, and hearing and all medically necessary services. The Contractor shall identify all EPSDT eligible Members whose Medical Records do not indicate up-to-date immunizations and shall ensure that these Members receive necessary immunizations. The Division requires that the Contractor cooperate to the maximum extent possible with efforts to improve the health status of Mississippi citizens, and to actively work to improve the percentage of Members receiving appropriate screenings. EPSDT wellness (screening) services shall be administered in accordance with Mississippi Administrative Code, State Plan and written communication from the Division to the Contractor. For CMS mandatory reporting purposes, including but not limited to CMS 416 reporting, EPSDT wellness (screening) services must be provided by enrolled Medicaid providers, including, but not limited to, the Mississippi State Department of Health, other public and private agencies, private physicians, Rural Health Clinics, comprehensive health clinics, public schools and/or public school districts certified by the Mississippi Department of Education and similar agencies which provide various components of the EPSDT services, that have signed an EPSDT specific provider agreement with the Division. The Division will provide the Contractor with a list of qualified EPSDT providers on a monthly basis. EPSDT providers who have not signed an EPSDT specific agreement with the Division shall not submit claims with preventive Medicine CPT codes. The Division will provide the Contractor with a list of q...
EPSDT Services. The benefit package includes the delivery of the Federally mandated Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services as set in forth MAD Program Manual Section MAD-740, EPSDT SERVICES.
EPSDT Services. Provider, as applicable, shall comply with the Early and Periodic Screening, Diagnosis, and Treatment (“EPSDT”) statute and federal regulations and ensure that medical, vision and hearing screening components and immunizations are provided in accordance with the American Academy of Pediatrics periodicity schedule.
EPSDT Services. The Contractor shall comply with 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 that require EPSDT services to include outreach and informing, screening, tracking, and, diagnostic and treatment services. The Contractor must have written policies and procedures related to the provision of the full range of EPSDT services as defined in, and in accordance with, the Division's policies and procedures for EPSDT and the provisions of this Contract. Such services shall include, without limitation, periodic health screenings and appropriate and up-to- date immunizations using the ACIP Recommended Immunization Schedule of all Members age one (1) or under one (1), in accordance with the Periodicity Schedule established for EPSDT services, including periodic examinations for vision, dental, and hearing and all medically necessary services. The Contractor shall identify all Members age one (1) or under one (1) whose Medical Records do not indicate up-to-date immunizations and shall ensure that these Members receive necessary immunizations. The Division requires that the Contractor cooperate to the maximum extent possible with efforts to improve the health status of Mississippi citizens, and to actively work to improve the percentage of Members receiving appropriate screenings, and meet or exceed the percentage of screenings for the Medicaid Fee-for-Service population. The following minimum elements must be included in the Periodic Health Screening Assessment:
EPSDT Services. The Contractor must comply with the requirements regarding EPSDT services as set forth in Exhibit J of this Agreement, EPSDT Guidelines. The Contractor must also adhere to specific Department regulations at 55 Pa. Code Chapters 3700 and 3800 as they relate to EPSDT examination for individuals under the age of 21 and entering substitute care or a child residential facility placement.
EPSDT Services. 31 9. Emergency Room (ER) Services .....................................32 10. Post-Stabilization Services ......................................33 11. Examinations to Determine Abuse or Neglect .......................33 12.
EPSDT Services. A. The Contractor shall comply with EPSDT program requirements and performance standards found below.
EPSDT Services. The Contractor shall provide EPSDT services to all Enrolled Members under twenty-one (21) years of age in accordance with law.
