By Joe Touschner
Along with ICHIA and SLMB, one of the more inscrutable acronyms in health policy is EPSDT. Even those who know it stands for Early and Periodic Screening, Diagnosis, and Treatment may not know exactly who it is for and what it entails. Worse, although it is a federal policy that applies in Medicaid nationwide, EPSDT varies in important dimensions from state to state. Helpfully, a new resource from the National Academy for State Health Policy brings us consolidated information on what EPSDT means in states across the country.
Early and Periodic Screening, Diagnosis, and Treatment is the benefit standard that applies to children enrolled in Medicaid. Rather than being a specific set of health care services, it sets a standard for when children are entitled to benefits under Medicaid. Federal rules state that EPSDT means (1) Screening and diagnostic services to determine physical or mental defects in beneficiaries under age 21; and (2) Health care, treatment, and other measures to correct or ameliorate any defects and chronic conditions discovered. Further description is provided at 42 CFR 441.50-62.
States, though, have many choices in implementing EPSDT and NASHP’s new resources collect information on many of those choices. The web pages offer information on:
- General and specific definitions of medical necessity used by states
- Initiatives to improve access to preventive and treatment services for children
- Reporting and data collection strategies around children’s services
- Approaches to behavioral health screening and service delivery
- Resources developed to support providers and families
- Initiatives to improve care coordination for children
- Oral health service delivery for children
The site currently lists info for 13 states and the District of Columbia—we look forward to seeing more added in the future. The pages seem like a great resource to help those who care about children’s coverage understand what their states provide through Medicaid and to compare across states.
