CMS Sub-regulatory Guidance on EPSDT with Former CMO of Medicaid Dr. Andrey Ostrovsky and Kellie Hans-Green

In this episode of the Self-Disclosed Podcast, host Patrick Gilligan sits down with two experts in the field of pediatric health: Dr. Andrey Ostrovsky, former Chief Medical Officer of the U.S. Medicaid Department, and Kellie Green, Director of Child and Family Health at CareSource. Together, they dive deep into the newly released sub-regulatory guidance surrounding the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit.

Join us as we explore the history of EPSDT, its importance in providing comprehensive behavioral health services to children and adolescents, and the implications of the recent guidance for health plans, providers, and families. The discussion highlights the need for individualized approaches to care, particularly for vulnerable populations such as children in foster care and those with special healthcare needs.

Discover how this guidance can empower families, improve access to necessary services, and potentially reshape the landscape of pediatric healthcare. We also discuss the role of advocacy, the importance of understanding Medicaid, and how families can navigate the complexities of the system to ensure their children receive the care they deserve.

Tune in for an insightful conversation that aims to shed light on the critical issues affecting children's health and the opportunities for improvement in the healthcare system.

Key Topics:

• Overview of EPSDT and its historical context
• The significance of the new EPSDT guidance
• Behavioral health services for children and adolescents
• Advocacy for families navigating the Medicaid system
• The role of value-based care in improving health outcomes

Don't forget to like, subscribe, and hit the notification bell for more episodes on important health topics!

Timestamps

00:00:00 - Introduction to EPSDT and Peer Support

00:01:33 - Welcome and Episode Overview

00:02:11 - History of EPSDT and Legislative Background

00:05:12 - EPSDT from the Health Plan Perspective

00:05:59 - Inspiration Behind the New Guidance

00:08:12 - Clarifying EPSDT for Behavioral Health

00:09:57 - Impact of New Guidance on Vulnerable Populations

00:11:20 - Higher Standards of Coverage for Children

00:13:27 - Implications of the New Guidance

00:18:08 - State Responses to Sub-Regulatory Guidance

00:20:12 - Opportunities for Improvement in Foster Care

00:22:29 - Empowering Families through EPSDT

00:24:29 - Advocacy and Engagement for Families

00:27:27 - Value-Based Payment Models and EPSDT

00:30:25 - Financial Implications of EPSDT and Prior Auth

00:34:48 - Advocating for Change: Family Perspectives

00:42:09 - Closing Thoughts and Acknowledgments