WEST VIRGINIA HEALTHCHECK
What is HealthCheck?
HealthCheck is the name for West Virginia’s EPSDT Program. EPSDT is a federally mandated comprehensive health care benefit package for all Medicaid enrolled individuals under the age of 21. The primary emphasis of EPSDT is preventive care.
Why HealthCheck screening?
It is important for children and young adults to see a primary care doctor, physician assistant or advanced practice registered nurse on a regular basis to stay healthy. Check-up intervals, or periodicity, are in accordance with Bright Futures and the American Academy of Pediatrics recommendations for preventive pediatric health care.
What are the required screening components?
Screening services are the foundation of the EPSDT Program. Required screening services include:
• Patient and family medical history including identifying risk factors
• Head-to-toe physical exam
• Developmental screening
• Hearing screening
• Vision screening
• Oral health screening
• Laboratory tests (including lead toxicity screening)
• Age-appropriate immunizations
• Age-appropriate anticipatory guidance and health education
How does HealthCheck ensure that complete care is provided when a problem is identified?
Any physical or mental health condition identified during a HealthCheck screening visit must be fully assessed. Medically necessary treatment must be provided to ensure that each child remains as healthy as possible and achieves his/her maximum level of functioning.
What about referrals?
Referrals are an important component of the HealthCheck Program. All EPSDT treatment services must be medically necessary to correct or ameliorate a physical or mental health condition. The need for specialist referral or treatment must be documented during an EPSDT screen. Any specialist providing services must coordinate service needs with the primary care provider.
For more assistance:
Regional Program Specialists equip providers with the necessary tools and knowledge to carry out EPSDT screening services. Program Specialists also supervise a state wide network of outreach staff who contact families of eligible children and link them with providers.
You may speak with the Regional Program Specialist in your area by calling:
West Virginia HealthCheck Program