Last page edit 04/21/08

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Early Periodic Screening, Diagnosis & Treatment Program (EPSDT) Summary (Maryland)

Name   Early Periodic Screening, Diagnosis & Treatment Program (EPSDT)
Non-Financial Eligibility Conditions   Children under 21 years old and must be eligible for Medical Assistance
Income Eligibility Conditions   Must be eligible for Medical Assistance; Income below "medically needy income level" for household size, or "incurred" medical expenses equal the "spend down" amount by which income exceeds the income limit.
Asset Eligibility Conditions   Must be eligible for Medical Assistance.
Benefit   Periodic health screening, diagnosis, and treatment for children; includes vision, hearing, and dental assessments; may also cover screening for physical, mental, or developmental problems when needed.

How are benefits calculated?
Apply At   Department of Social Services.  Find your local DSS Office
Appeals

  
  • Appeals must be filed in writing at the DSS office.  It is best to file it in person and to get a receipt showing that you filed the appeal.
  • Appeals must be filed within 90 days of the action, or you cannot appeal.
  • If you file within 10 days of notice that benefits are being terminated or reduced, they will continue until the decision.  If you do not appeal within 10 days, the termination or reduction will happen.
Source of the Funds   State and federal
Sources of Law

  

Federal Law: 42 U.S.C.  §1396d(r)  (Definition, services required...) This is a long page, and you will have to scroll most of the way down to find this section.

Federal Regulations: 42 CFR 441.50 to 441.62 Scroll down the page to find these numbered sections.  You can read the documents either as Acrobat PDF files or as plain text.

State Law:

State Regulations: COMAR 10.09.23.00 to 10.09.23.9999; Scroll down the list of chapters to "Chapter 23 - Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Screening Services." Click the Chapter title to open the list of regulations.

Source: Maryland Legal Assistance Network (MLAN), updated by the Maryland State Law Library (MSLL).

Last legal review 4/3/08 (PLL/M.A.J)
 
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