EPSDT

CMS Affirms States Must Cover Stand-Alone Vaccine Counseling under EPSDT, More Work to Be Done

As families and parents across the country eagerly await approval of the COVID-19 vaccine for children under 5, new guidance from CMS reaffirms that states must cover stand-alone vaccine counseling for children covered by Medicaid under EPSDT. According to guidance released last week, CMS reiterates that under Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment […]

Oregon’s Waiver Proposal: Continuous Eligibility for Young Children as a School Readiness Tool, But Why Not EPSDT?

As my colleagues blogged last week, Oregon released its 1115 waiver proposal for state public comment, which included precedent-setting concerns and innovations. We were pleased to see multi-year continuous eligibility included—up to five years for children under age 6, and two years for ages 6 and older. While a few states are in various stages […]

GAO To CMS: Set Goals, Measure Progress on EPSDT (Do Better)

Another day, another area where CMS could be spending its valuable resources to fulfill Medicaid’s mission to provide health care to low-income Americans, including and especially children. The Government Accountability Office (GAO), Congress’s watchdog for federal agencies, has some ideas. Regular Say Ahhh! readers know the great potential of Medicaid’s pediatric benefit, called EPSDT. Medicaid […]

California’s Mandate to Treat Children on Medi-Cal Is Now a Little Clearer

The Medicaid Act, the federal law governing California’s Medi-Cal Program, has long contained specific benefit requirements for covering children and youth under the age of 21 through the Early and Periodic Screening, Diagnostic and Treatment – or “EPSDT” – services mandate. Despite its unmemorable name, this federal mandate critically identifies that children and adolescents are […]