New EPSDT Guidance Reinforces Key Medicaid Prior Authorization Protections for Children – And We’d Like to See Even More

Everyone under the age of twenty-one in Medicaid should have access to health care services they need thanks to Medicaid’s Early and Periodic Diagnostic Screening and Treatment (EPSDT) requirement. In short, EPSDT requires children to get regular screenings and treatment when necessary. And this isn’t a vague hope – it’s the law. However, in at […]

CMS EPSDT Guidance Blog Series

CMS released a state health official (SHO) letter outlining the requirements states and managed care plans must meet under Medicaid’s pediatric benefit, known as Early and Periodic Screening, Diagnostic and Treatment or EPSDT. The EPSDT SHO also describes some strategies and identifies best practices currently in use by states to meet the various requirements. This […]

Urban Institute Report on Parent Health Coverage Finds Mothers of Young Children Showed Greatest Gains

Last month, the Urban Institute released a report detailing uninsurance rates between 2019 and 2022 for families with young children (under age 3).  The report revealed significant drops—for the children, for fathers, and most significantly, for mothers.  There were multiple factors contributing to these rises in coverage rates—pandemic-era continuous enrollment policies such as the Families […]

New Report Explores Insights from Medicaid Unwinding on How to Protect Children’s Coverage

The Urban Institute and Georgetown CCF have released a new report highlighting ways to improve the Medicaid/CHIP redetermination process for children emanating from key lessons learned during the unwinding of the Medicaid continuous coverage protection. These insights are based on interviews of representatives in 8 state Medicaid agencies, offering a unique perspective directly from the […]