Medicaid, SCHIP, and Medicare: EPSDT

Publications

Markus, A., Rosenbaum, S., Stewart, A., and Cox, M. How Medical Claims Simplification Can Impede Delivery of Child Developmental Services. The Commonwealth Fund, August 2005.

Rosenbaum, S., Mauery, D.R., Shin, P., and Hidalgo, J. National Security and U.S. Child Health Policy: The Origins and Continuing Role of Medicaid and EPSDT. GW Department of Health Policy; The Robert Wood Johnson Foundation. April 2005.

Rosenbaum, S., and Sonosky, C. Federal EPSDT Coverage Policy: An Analysis of State Medicaid Plans and State Medicaid Managed Care Contracts. December 2000.

This publication is available in multiple Adobe PDF files; please choose from the following list:

1. Executive Summary
2. EPSDT Presentation

• Chapter 1: State Medicaid Plan Analysis
• Table 1: Services
• Chapter 2: State Medicaid Necessity Standards
  • Table 2: State Definitions of Medical Necessity
• Chapter 3: Analysis of Contract Provisions Relating to EPSDT
  • Table 3(1)
  • Table 3(2)
  • Table 3 Data, part 1: Excerpts from EPSDT Contract Provisions
  • Table 3 Data, part 2: Excerpts from EPSDT Contract Provisions
• Chapter 4: Analysis of Contract Provisions Relating to Medical Necessity
  • Table 4(1)
  • Table 4(2)
  • Table 4 Data: Excerpts from Medical Necessity Contract Provisions
• Chapter 5 Table: SMRF States - 1905 Services Covered for Categorically Needy as of 1-1-95