Rule 23-223-1.1 - Program DescriptionA. The Division of Medicaid has established a program of Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) which provides screenings, preventive and comprehensive health services for certain beneficiaries who are eligible for full Medicaid benefits. EPSDT services are provided to beneficiaries under age twenty-one (21).B. EPSDT stands for: 1. Early is assessing health care in early life so that potential disease and disabilities can be prevented or detected in their preliminary states, when they are most effectively treated. 2. Periodic is assessing a child's health at regular, recommended intervals in the child's life to assure continued healthy development.3. Screening is the use of tests and procedures to determine if children being examined have conditions warranting closer medical or dental attention. 4. Diagnosis is the determination of the nature or cause of conditions identified by the screening.5. Treatment is the provision of services needed to control, correct or lessen health problems.C. Providers of EPSDT screenings must be currently enrolled Mississippi Medicaid providers, have signed an EPSDT specific provider agreement, and must adhere to the American Academy of Pediatrics (AAP) Bright Futures Periodicity Schedule. EPSDT screening providers include, but are not limited to: 1. The Mississippi State Department of Health,2. Public schools and/or public school districts certified by the Mississippi Department of Education,3. Federally Qualified Health Centers (FQHC), 4. Rural Health Clinics (RHC), 5. Comprehensive health clinics, and6. Similar agencies which provide various components of EPSDT screenings.D. EPSDT diagnostic and treatment services are primarily provided by referral to other enrolled Mississippi Medicaid providers.23 Miss. Code. R. 223-1.1
42 U.S.C. § 1396d; 42 C.F.R. Part 441, Subpart B; Miss. Code Ann. §§ 43-13-117, 43-13-121.Revised to correspond with SPA 2015-017 (eff. 11/01/2015)