What is Medicaid EPSDT?
The Medicaid EPSDT program is a fee-for-service system that provides a full array of health care services to children 21 and under. Medicaid is required to provide services that a physician has declared “medically necessary” to correct or ameliorate the child’s condition. Medicaid/DMAHS (Division of Medical Assistance & Health Services) often denies eligibility and reduces the amount of hours or days of a service) or terminates services, determinations that may lead to an appeal to OAL for the beneficiary. Attorneys at Hinkle, Fingles & Prior have successfully litigated these cases, securing such services as personal care assistance, home health aides, and therapy services appeals.
Related Questions
- B – 029If a Head Start child does not receive their physical examination within one year of their last physical (as required by Medicaid/EPSDT), can the child be expelled from Head Start?
- B – 012How should a Head Start program cover the costs of providing health services to an enrolled child if the child’s family is not eligible for Medicaid/EPSDT?
- What is Medicaid EPSDT?
