EPSDT

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 […]

CMS Issues Guidance to States on Early and Periodic Screening, Diagnostic and Treatment Requirements

Today, the Centers for Medicare & Medicaid Services (CMS) released much-anticipated guidance on Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) requirements. For those who don’t live in Medicaid jargon land, EPSDT is the pediatric benefit in Medicaid and establishes a higher standard for children than adults covered by Medicaid. Most, but not all, […]