Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1241 - EARLY AND PERIODIC SCREENING, DIAGNOSIS AND TREATMENT PROGRAM
GENERAL PROVISIONS
Section 1241.2 - Definitions

The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:

Administrative contractor-A nonprofit organization engaged in health care management that has contracted with the Department to be responsible for the coordination of existing, and the development of new screening resources to serve the eligible population in assigned geographical areas. The administrative contractor shall be accountable to the Department for the quality of services rendered and for fulfilling other responsibilities specified in this chapter.

EPSDT Program-Early and Periodic Screening, Diagnosis and Treatment Program.

Eligible Child-An individual 20 years of age or younger who is eligible for a Public Assistance cash grant or Supplemental Security Income (SSI) or an individual 20 years of age or younger who does not receive a cash grant and whose annual income and resources do not exceed certain limits based on family size.

Screening-The direct provision of testing and evaluation services provided by certified EPSDT screening providers for eligible children in order to ascertain diseases or abnormalities requiring diagnosis and treatment.

Screening provider-A licensed physician, a group of licensed physicians or an appropriate agency such as a hospital, health center or health department which uses the services of licensed physicians. The provider shall be able to provide either directly or through referral facets of general pediatric services to MA and non-MA children.