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D.C. Children Don't Receive Complete Health Screens Required by Law

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Abstract:

Children covered by Medicaid are entitled to thorough health screenings and treatment for any problems identified by these screenings. The requirements for the early and periodic screening, diagnosis, and treatment program (EPSDT) are laid out in explicit detail in federal Medicaid law. Under this law, states are required to work with recognized medical organizations, such as the American Academy of Pediatrics, and locally recognized medical and dental organizations to develop schedules for children' s health screening and immunizations (called "periodicity schedules"). States are required to notify families about the EPSDT program within 60 days after children are found eligible for Medicaid. When children do not receive EPSDT services during the year, the state must remind the family about the availability of EPSDT. In addition to requiring its eligibility workers inform families about EPSDT services, the District of Columbia, like many states, requires its contracting Medicaid managed care plans to inform families about EPSDT services and to provide the care required by the program.