HealthCheck Provider Education System

HealthCheck Training

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Overview

Health Supervision

Special Health Issues

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Overview

HealthCheck Summaries: Eligible Participants and Providers

Descriptive HealthCheck Program Summaries

The following pages contain summaries describing important administrative aspects of the HealthCheck Program including:

  • Eligible Participants and Providers.
  • Recipient Support Services.
  • Program Coordination and Outreach.

 

Participants and Providers

Eligible Children and Teens

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HealthCheck Program services are provided to children and adolescents under age 21 who are eligible for Medicaid, including:

  • Temporary Assistance for Needy Families (TANF) children.
  • Newborns born to women eligible for and receiving medical assistance.
  • Foster children.
  • DC Healthy Families Program (DCHFP) children.
  • Children and adolescents eligible for Supplemental Security Income (SSI) and SSI-Related Plan (CASSIP).

 

Eligible Providers

All DC Medicaid Managed Care primary care providers (PCPs) are responsible for providing HealthCheck screening services to patients up to age 21.

PCPs in the

  • Pediatricians
  • Family practitioners
  • General practitioners
  • Internists
  • Nurse practitioners
  • Gynecologists

States cannot limit EPSDT providers to only those who can provide all mandated diagnostic and treatment services.

 

Choosing Providers

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Families enrolled in a Managed Care Organization (MCO)1 are required to choose a provider or one will be chosen for them.

Enrollees should choose a PCP who will provide their medical care and will coordinate the delivery of care from other providers when necessary.

Many enrollees may continue to see the PCP they have being seeing under another health program. The PCP provides consistent health care and a medical

 

Mental Health Services Responsibilities

The following describes responsibilities for mental health services within the HealthCheck Program:

  • CASSIP MCOs - Providing and arranging for behavioral health and substance abuse services
  • DCHFP MCOs - Referring beneficiaries for behavioral and mental health services
  • Addiction, Prevention and Recovery Administration - Selecting providers for treatment of alcohol and drug abuse
1 An MCO is a prepaid, capitated plan.

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