Current through September 24, 2024
A. An initial or established age-appropriate
medical screening which must include at a minimum:
1. A comprehensive health and developmental
history including assessment of both physical and mental health development and
family history,
2. A comprehensive
unclothed physical examination,
3.
Appropriate immunizations according to the Advisory Committee on Immunization
Practices (ACIP), and specific to age and health history,
4. Laboratory tests adhering to the AAP
Bright Futures Periodicity Schedule,
5. Sexual development and sexuality screening
adhering to the AAP Bright Futures Periodicity Schedule, and
6. Health education, including anticipatory
guidance.
B.
Developmental screening or surveillance to include diagnosis with referral to
an enrolled Mississippi Medicaid provider for diagnosis and treatment for
defects discovered.
C.
Psychosocial/behavioral assessment to include diagnosis with referral to an
enrolled Mississippi Medicaid provider for diagnosis and treatment for defects
discovered.
D. Vision screening, at
a minimum, to include diagnosis with referral to an enrolled Mississippi
Medicaid optometry or ophthalmology provider for diagnosis and treatment for
defects discovered.
E. Hearing
screening, at a minimum, to include diagnosis with referral to an enrolled
Mississippi Medicaid audiologist, otologist, otolaryngologist or other
physician hearing specialists for diagnosis and treatment for defects
discovered.
F. Dental screening, at
a minimum, to include diagnosis with referral to an enrolled Mississippi
Medicaid dental provider for beneficiaries at eruption of the first tooth or
twelve (12) months of age for diagnosis and referral to a dentist for treatment
and relief of pain and infections, restoration of teeth and maintenance of
dental health.
G. Maternal
depression screening, to include a referral:
1. To an enrolled Medicaid provider if the
mother is eligible for Medicaid, or
2. To other healthcare providers as medically
indicated including, but not limited to:
a)
Federally Qualified Health Center (FQHC),
b) Rural Health Clinic (RHC), or
c) Community Mental Health Center
(CMHC).
H.
The Division of Medicaid covers off-site screening at the following locations:
1. School,
2. Day care center, or
3. Head start center.
I. Off-site Early and Periodic Screening,
Diagnosis, and Treatment (EPSDT) screening providers must:
1. Provide off-site screenings only within
the county or within forty (40) miles of the county where the physician's
office is located,
2. Develop and
adhere to confidentiality policies that are approved by the Division of
Medicaid.
3. Ensure medical
personnel performing the physical examination are limited to Mississippi
Medicaid enrolled physicians, nurse practitioners or a physician assistants
employed by the physician's office.
4. Complete all age-appropriate components of
the EPSDT screening during one (1) visit or encounter.
5. Have a designated well-lit private room to
perform the screening assessments which must be in close proximity to:
a) Hot and cold running water, and
b) A bathroom.
6. Obtain written parental/guardian consent:
a) The written consent must contain the
following statements:
1) Parent/guardian right
to be present during EPSDT screenings,
2) The physical examination will be
unclothed,
3) The EPSDT screenings
take the place of the yearly wellness exam performed at the beneficiary's
primary care provider's office, and
4) Vaccines will be administered, if
applicable,
b) Must
include a space for the parent/guardian signature and date giving approval for
the EPSDT screenings to be performed, and
c) Must be received within sixty (60) days
prior to the EPSDT screenings.
7. Encourage the parent/guardian to be
present during the EPSDT screenings,
8. Follow-up with the parent/guardian on the
results of the screening by mail or in a one-on-one meeting.
9. Utilize the anticipatory guidance
materials that are:
a) Age
appropriate,
b) Mailed to the
parent/guardian for beneficiaries under the age of fourteen (14).
c) Given to beneficiaries fourteen (14) years
of age and above.
J. The Division of Medicaid does not
reimburse for services other than EPSDT screenings in an off-site location.
42
U.S.C. §
1396d; 42 C.F.R Part 441,
Subpart B; Miss. Code Ann. §§
43-13-117,
4313-121.
