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Scope of Health Care Benefits for Neonates, Infants, Children, Adolescents, and Young Adults Through Age 26.
Pediatrics ( IF 8 ) Pub Date : 2022-09-01 , DOI: 10.1542/peds.2022-058881
Mark L. Hudak 1 ,
Affiliation  

Timely access to appropriate health care from the prenatal period onward is one of several pillars essential to optimize the health of a child preparing to become an adult. In 1967, Congress passed legislation that specified an Early and Periodic Screening, Diagnostic and Treatment standard as the mandatory child health component of Medicaid. Subsequent legislative amendments have generally strengthened this standard. In particular, state Medicaid programs must provide any health care service for children that is covered by the federal Medicaid program even if the state does not cover that service for adults. An initial set of detailed recommendations concerning the best preventive care services for children, adolescents, and young adults was published in 1994 based on deliberations of a large group of expert pediatric health care providers and family representatives. The most recent updated recommendations are available in the 2017 fourth edition of Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. The Patient Protection and Affordable Care Act of 2010 (Pub L No. 114-148) referenced Bright Futures recommendations as a standard for access to and design of age-appropriate health insurance benefits for neonates, infants, children, adolescents, and young adults. This policy statement summarizes recent developments pertaining to the scope of health care benefits offered for children by public and private payers. The statement identifies barriers that impede achievement of a uniform standard that all payers can adopt. Finally, the statement refreshes a recommended set of health insurance benefits for neonates, infants, children, adolescents, and young adults through age 26.

中文翻译:

新生儿、婴儿、儿童、青少年和 26 岁以下年轻人的医疗保健福利范围。

从产前开始及时获得适当的医疗保健是优化准备成年的儿童健康的几个重要支柱之一。1967 年,国会通过立法,将早期和定期筛查、诊断和治疗标准指定为医疗补助的强制性儿童健康部分。随后的立法修订普遍加强了这一标准。特别是,州医疗补助计划必须为联邦医疗补助计划涵盖的儿童提供任何医疗保健服务,即使该州不为成人提供该服务。一套初步的详细建议,涉及儿童、青少年、1994 年出版了基于大量专家儿科保健提供者和家庭代表的审议。最新更新的建议可在 2017 年第四版《光明未来:婴儿、儿童和青少年健康监督指南》中找到。2010 年《患者保护和平价医疗法案》(Pub L No. 114-148)将 Bright Futures 的建议作为获得和设计新生儿、婴儿、儿童、青少年和年轻人适龄健康保险福利的标准。本政策声明总结了与公共和私人支付者为儿童提供的医疗保健福利范围有关的最新发展。该声明确定了阻碍实现所有付款人都可以采用的统一标准的障碍。最后,
更新日期:2022-08-29
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