August 15, 2009

Medicaid Preventive Services: Concerted Efforts Needed to Ensure Beneficiaries Receive Services

The Government Accountability Office (GAO) sought to determine the extent that Medicaid beneficiaries have certain health conditions and receive preventive services. GAO analyzed survey data from the National Health and Nutrition Examination Survey, which includes physical examinations of participants, and the Medical Expenditure Panel Survey. Both are nationally representative. GAO also surveyed state Medicaid directors and interviewed federal officials. GAO found that although the Centers for Medicare and Medicaid Services (CMS) intends that at least 80% of Medicaid-eligible children receive well-child check-ups through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, nationally representative survey data collected from 2003 through 2006, shows that about 41% of eligible children did not receive a well-child check-up within a two-year period.