The Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit offers health care coverage specifically targeted to meet the needs to low-income children and children with disabilities. This article provides a brief overview of EPSDT and then discusses how states are working to bring vision, hearing, and oral health services to children through EPSDT.
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References
1.
S.Ruiz, Centers for Medicare & Medicaid Services, Division of Quality and Health Outcomes, “Ensuring Access to Vision, Hearing and Oral Health Care,”Remarks at the Public Health Law Conference, September 17, 2016.
2.
See 42 U.S.C. §§ 1396a(a)(10)(A), 1396a(a)(43), 1396d(a)(4) (B), 1396d(r).
3.
See H.R. Rep. No. 101-247, at 399 (Sept. 20, 1989), reprinted at 1989 U.S.C.C.A.N. 1906, 2125; see also CMS, State Medicaid Manual § 5240.
4.
42 U.S.C. § 1396a(a)(43)(C).
5.
Id. § 1396d(r)(5) (referring to 42 U.S.C. § 1396d(a)).
6.
Id.
7.
Stanton v. Bond, 504 F.2d 1246, 1251 (7th Cir. 1974).
42 U.S.C. § 1396d(r)(2); see also, e.g., CMS, EPSDT-A Guide for States, supra note 9, at 15-16.
12.
See Vision Services for Children on Medicaid, supra note 10, at 14-15.
13.
Network for Public Health Law & National Health Law Program, Model Medicaid Managed Care Contract Provisions: EPSDT Vision and Hearing Services at 8 (May14, 2015), available at <https://www.networkforphl.org/_asset/700x9x/SURVEY_MEDICAID_MANAGED_CARE_CONTRACTS.pdf (last visited January 23, 2017) (hereinafter Model Medicaid Managed Care Contract Provisions).
14.
See Vision Services for Children on Medicaid, supra note 10, at 19.
42 U.S.C. § 1396d(r)(4); see also, e.g., CMS, EPSDT — A Guide to States, supra note 9, at 14-15.
17.
See Hearing Services for Children on Medicaid, supra note 15, at 14.
18.
Model Medicaid Managed Care Contract Provisions, supra note 13, at 25.
19.
CMS, Keep Kids Smiling: Promoting Oral Health through the Medicaid Benefit for Children & Adolescents (September2013), at 5 (on file with author).
20.
42 U.S.C. § 1396d(r)(3).
21.
CMS, EPSDT-A Guide for States, supra note 9, at 13.
22.
Iowa Department of Public Health, “Maternal and Child Health Dental,”available at <http://www.idph.iowa.gov/ohds/oral-health-center/maternal-child-dental> (last visited January 23, 2017). Title V, the nation's oldest federal-state partnership program, is authorized by 42 U.S.C. § 701 et seq.
23.
Children's Health Alliance of Wisconsin, Wisconsin Department of Health Services, Delta Dental of Wisconsin, Wisconsin Seal-a-Smile Administration Manual (May2016), available at <http://www.chawisconsin.org/documents/OH2SASAdmin-Manual.pdf> (last visited January 23, 2017).
24.
M.Booth, Executive Director, Children's Dental Health Project, “Ensuring Access to Vision, Hearing & Oral Health Care,”Remarks at the Public Health Law Conference, September 17, 2016.
