CMS Needs to Do More to Improve Medicaid Children’s Utilization of Preventive Screening Services

In 2010, a report from the Office of Inspector General (OIG) was released detailing findings of children enrolled in Medicaid who were not receiving all required Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) screenings, nor were they receiving complete medical screening. Based on four recommendations from OIG, the Centers for Medicare and Medicaid Services (CMS) has taken steps towards encouraging children’s participation in these screenings and ensuring proper medical screenings.

Through interviews with the CMS staff, representatives of workgroups relating to EPSDT issues, and reviewing States’ reports on EPSDT participation, CMS found that since 2010, action has been taken to address the recommendations laid out by OIG, but they have not fully addressed each problem area. While children’s participation in EPSDT screenings have increased from 56 percent in 2006 to 63 percent in 2013, these are still below the Secretary’s 80 percent participation goal. Based on these findings, OIG believes all four of the same 2010 recommendations from the report need to stay open.

Read the full report.