For Medicaid-enrolled children diagnosed with lead toxicity in five states, documentation reviewed for diagnoses and treatment services raises concerns
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Report in brief (United States. Department of Health and Human Services. Office of Inspector General)
- Contributor(s):
- United States. Department of Health and Human Services. Office of Inspector General. Office of Evaluation and Inspections, issuing body.
- Publication:
- Washington, D.C. : U.S. Department of Health and Human Services, Office of Inspector General, December 2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Child Data Accuracy Government Regulation Lead Poisoning -- diagnosis Lead Poisoning -- prevention & control Lead Poisoning -- therapy Medicaid United States
- Genre(s):
- Technical Report
- Abstract:
- Why OIG Did This Review. Lead toxicity is an environmental health concern that can have lasting effects on the lives of children. Although there is no safe level of lead exposure for young children, exposure is preventable. Children’s exposure to lead can be minimized through actions such as regular cleaning of the home; washing of hands and toys; and preventive care to support early detection of lead toxicity and timely followup testing and treatment services. An Office of Inspector General (OIG) report issued in October 2021 found that more than one-third of Medicaid-enrolled children in five States (California, New York, Ohio, Pennsylvania, and Texas) did not receive required blood lead screening tests during fiscal years (FYs) 2015–2018, which potentially left children vulnerable to the toxic effects of lead exposure. This study expands on that work. How OIG Did This Review. For the same States noted above, we reviewed Medicaid claims data for FYs 2015–2018. From this data, we selected a sample of 625 enrolled children with a diagnosis indicating lead toxicity, and reviewed children’s medical records from the date of diagnosis through 6 months later. The review examined whether children received followup testing and treatment services for their identified blood lead levels (FYs 2015–2019), as recommended by the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC). We also collected public health data from four States to account for services provided exclusive of Medicaid payment and received outside clinical settings, and we asked medical reviewers to consider the respective State medical management guidance. Finally, we interviewed stakeholders regarding followup testing and treatment services for children exposed to lead.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (44 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918716088706676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918716088706676