CMS Releases Guidance on Early and Periodic Screening, Diagnostic, and Treatment Compliance

On September 26, 2024, CMS released guidance for compliance with the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) requirements under Medicaid and the Children's Health Insurance Program (CHIP). The guidance is intended to provide an overview of EPSDT requirements and how states can meet the goal of providing a comprehensive array of prevention, diagnostic, and treatment services for low-income infants and children under the age of twenty-one. The guidance focuses on three broad topics: (1) promoting EPSDT awareness and accessibility, (2) expanding and using the child-focused (EPSDT) workforce, and (3) improving care for EPSDT-eligible children with specialized needs.  The guidance provides policies, strategies, and best practices for states to implement these goals.  

While CMS ensures that states meet federal requirements in operating Medicaid and CHIP, federal law also gives states options for implementing their programs in a manner suited to their communities’ needs.  Although state strategies for meeting the EPSDT requirements may vary, the new guidelines published by CMS will be a helpful starting point for developing effective avenues to comply with EPSDT requirements.