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CMS releases guidance on EPSDT requirements for Medicaid and CHIP; document outlines best practices for increasing access, expanding workforce, improving care for children with specialized needs

September 26, 2024 (press release) –

The Centers for Medicare & Medicaid Services Sept. 26 released guidance on state compliance with the Early and Periodic Screening, Diagnostic and Treatment requirements under Medicaid and the Children's Health Insurance Program. The guidance explains statutory and regulatory EPSDT requirements and suggests best practices, such as increasing access through transportation and care coordination services, leveraging incentives, sanctions and contractual requirements in the Medicaid managed care programs, expanding the children-focused workforce, improving care for children with specialized needs (including children in the child welfare system and children with disabilities), and expanding families' awareness of their children’s rights under EPSDT requirements. The guidance also includes information, strategies and best practices to address the needs of children with behavioral health conditions.

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