SECTION 340:70-9-5. Mandatory offer of Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

(a)   Section 1902 of Title XIX of the Social Security Act requires that all persons under 21 years of age who are determined eligible for SoonerCare must be informed of the availability of Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services:

(1)   within 60 days of the initial eligibility determination; and

(2)   on an annual basis.

(b)   The Oklahoma Department of Human Services (OKDHS) mails at the time of each certification, and each year thereafter, a written notice to eligible SoonerCare recipients informing them of the availability of EPSDT services.

(c)   Special arrangements must be provided for recipients who do not read or understand English.

(1)   Recipients unable to read or understand written English are informed through face-to-face contact by the worker of the availability of EPSDT services.

(2)   When necessary, the worker arranges for the assistance of a second-language translator, either from among members of the recipient's family or other community resources. For visually handicapped or illiterate English-speaking recipients, the worker reads and explains the written notice of EPSDT availability.

(d)   Persons who apply at a SoonerCare outreach facility are advised of the availability of EPSDT services at the time their SoonerCare applications are processed or completed.

(e)   When the offer of EPSDT services is made face-to-face to any eligible recipient, the worker provides the recipient with a copy of OKDHS Pub. No. 87-36, Early and Periodic Screening, Diagnosis and Treatment. The worker discusses preventive health services, including EPSDT in language appropriate for the recipient's level of understanding.

(f)   If the medical provider finds an abnormality at the time of the screening, the provider notes this when filing a claim for payment. The results of the screening and abnormal finding are provided to OKDHS and appears on the worker's CWA report.

[Source: Amended at 11 Ok Reg 825, eff 12-14-93 (emergency); Amended at 11 Ok Reg 1705, eff 5-12-94; Amended at 19 Ok Reg 1785, eff 6-14-02; Amended at 24 Ok Reg 2191, eff 7-1-07]