PDF Version: What is Kan-Be-Healthy/EPSDT?
PDF Version: Full Guide of all 30+ Flyers (Compiled as a Booklet)
EPSDT stands for Early and Periodic Screening, Diagnostic, and Treatment. It is part of the federal Medicaid program which provides health and long-term care. Kansas must provide EPSDT to people under 21. In Kansas, EPSDT is called the Kan-Be-Healthy program.
Kan-Be-Healthy (EPSDT) requires that children get the healthcare and other services that they need. It covers anything Medicaid covers if those services will help with a condition or make it easier to live with. The services must be medically necessary.
What is covered under Kan-Be-Healthy?
There are four screenings that Kan-Be-Healthy can cover.
- Vision screenings – This includes eye glasses.
- Hearing screenings – This includes hearing aids and other devices that can help with communication.
- Dental screenings – This includes routine cleanings and x-rays.
- Medical screenings – This includes health and developmental examinations, immunizations, laboratory testing, long-term care needs, health, education and guidance.
Any condition or issue discovered under one of the above screens MUST be addressed and covered with health and long-term care services by Kan-Be-Healthy. Other examples of services that must be covered under Kan-Be-Healthy are home health services, attendant care services, in-home nursing services, and medical respite services. The key is that your doctor must note the condition on the screen they conduct for Kan-Be-Healthy.
How do I get Kan-Be-Healthy services for my child?
Meet with your child’s doctor to talk about what your child might need. Have the doctor do a new screen detailing what is needed. The doctor will also need to document that the services that you talk about are medically necessary. They can do this with a letter from your child’s doctor explaining why the service is medically needed. The doctor can also explain your child’s disability in the letter.
Use the Kan-Be-Healthy screening form and checklist:
KDHE’s Kan-Be-Healthy Screening Form
Checklist of EPSDT Services
The screening form is what you will submit to request Kan-Be-Healthy services. Your child’s doctor needs to fill out the screening form.
Submit the form to your child’s managed care organization (MCO). They have to respond to your request. They will mail you a “Notice of Action.” This will say if your request is approved or denied.
If the request is approved, the MCO begins the process of getting services for your child. If the request is denied, the notice will include how to appeal the decision. If you want to appeal, make sure you keep the Notice of Action. You must appeal within 33 days of the denial. If you need help with this, contact the Disability Rights Center of Kansas.
Sources & Additional Resources
EPSDT and Kan-Be-Healthy Early Periodic Screening, Diagnosis, and Treatment. Families Together, Inc.
Kan-Be-Healthy Screening Form. Kansas Department of Health and Environment.
EPSDT: Early Periodic Screening, Diagnosis, and Treatment. Disability Rights Center of Kansas, Inc.
Fact Sheet: Medicaid EPSDT Case Trends and Docket. Perkins, J. National Health Law Program.
Disclaimer: This fact sheet is not intended to provide specific legal advice. If you need legal advice, please contact an attorney. Only an attorney can give you specific legal advice based on your particular situation. We try to update our materials regularly, but the law can change frequently. This publication is based on the law at the time that it was written. Future changes in the law could make information in this fact sheet inaccurate.