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JUST THE FACTS: Medicaid & Screenings for Children in California

Medicaid EPSDT Screenings Reference List

“EPSDT is Essential,” (March 2017), National Health Law Program: http://www.healthlaw.org/issues/child-and-adolescent-health/epsdt/epsdt-is-essential-march-2017#.WV1uEzPMxmA 

“EPSDT: A Primer on Medicaid’s Pediatric Benefit,” (March 2017),Georgetown Center for Children and Families: https://ccf.georgetown.edu/wp-content/uploads/2016/03/EPSDT-fact-sheet.pdf 

“EPSDT - A Guide for States: Coverage in the Medicaid Benefit for Children and Adolescents,” (June 2014), Centers for Medicare & Medicaid Services: https://www.medicaid.gov/medicaid/benefits/downloads/epsdt_coverage_guide.pdf  

Improving the Lives of Young Children: The Role of Developmental Screenings in Medicaid and CHIP,” (December 2010), Urban Institute: http://www.urban.org/sites/default/files/publication/29436/412275-Improving-the-Lives-of-Young-Children-.PDF 

Endnotes

1 Page 1 of CMS, “EPSDT – A Guide for States” (June 2014), https://www.medicaid.gov/medicaid/benefits/downloads/epsdt_coverage_guide.pdf 

2 CMCS Informational Bulletin from Director Vikki Wachino, “The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit for children and youth in managed care,” (January 5, 2017), https://www.medicaid.gov/federal-policy-guidance/downloads/cib010517.pdf 

3 Bright Futures/American Academy of Pediatrics, “Recommendations for Preventive Pediatric Health Care,” (updated February 2017), https://www.aap.org/en-us/documents/periodicity_schedule.pdf 

4 See Department of Health Care Services guidance: All Plan Letter 14-017 (December 12, 2014) at http://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2014/APL14-017.pdf; Policy Letter 13-001 (October 8, 2013) at http://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/PL2013/PL13-001.pdf; and CHDP Provider Information Notice 16-03 (July 8, 2016) at http://www.dhcs.ca.gov/services/chdp/Documents/Letters/chdppin1603.pdf

5 See memo from Department of Health and Human Services Office of Inspector General, “Recommendation Followup Memorandum Report: CMS Needs to Do More to Improve Medicaid Children’s Utilization of Preventive Screening Services, OEI-05-13-1-00690,” (November 12, 2014), https://oig.hhs.gov/oei/reports/oei-05-13-00690.pdf

6 FY 2015 CMS-416 data, available at https://www.medicaid.gov/medicaid/benefits/epsdt/index.html

7 According to Children Now’s analysis of FY 2015 CMS-416 data, there were a total of 288,141 blood lead tests for children under 6, and there were 1,869,419 total individuals under age 6 eligible for EPSDT. 

This factsheet was prepared by Children Now in August 2017. For more information, please contact Mike Odeh, Director of Health Policy at modeh@childrennow.org or 510-763-2444 x122.