EPSDT at 60: How Medicaid's Pediatric Benefit Standard Shapes MCO Obligations and Child Health Outcomes

This retrospective examines the Early and Periodic Screening, Diagnostic, and Treatment benefit's comprehensive care standards for Medicaid enrollees under 21, including how it guarantees preventive and medically necessary services beyond typical adult coverage. The analysis addresses current operational challenges for managed care plans, including eligibility disruptions, provider network adequacy for pediatric specialty care, and MCO performance measurement around EPSDT compliance. It positions EPSDT's expansive benefit design as a foundational compliance requirement for Medicaid MCOs serving children and CHIP populations.

CHIP · Managed Care · Behavioral Health

This is outside commentary from Sellers Dorsey, not part of Medicaid Monitor's independently scored news coverage.

More from Sellers Dorsey