State Medicaid Programs Upped Lead Risks, HHS OIG Says (1)

Children in five states were placed at increased risk for lead exposure due to the missteps of local Medicaid programs, according to a Health and Human Services Department Office of Inspector General report released Tuesday.

California, New York, Ohio, Pennsylvania, and Texas Medicaid program records for children diagnosed with lead toxicity lacked the information necessary to accurately confirm a diagnosis. The findings come as part of a report compiled by the HHS Office of Inspector General diving into the medical records of 625 Medicaid-enrolled children.

“Among children for whom there was sufficient medical record documentation to confirm their diagnosis, many did not receive comprehensive follow-up testing and treatment services, as recommended, for their identified blood lead level,” the report said.

Without access to accurate medical information, states weren’t able to provide timely follow-up testing and treatment services, effectively putting children at risk for increased lead exposure. If untreated, lead exposure can lead to long-lasting and often permanent neurological damage, including lower IQ, behavioral deficits, and hearing and speech problems.

OIG is pushing for HHS’ Centers for Medicare and Medicaid Services to investigate why discrepancies exist between Medicaid claims data and medical documentation for lead toxicity—details that can help Medicaid programs provide comprehensive follow-up testing and treatment services.

The OIG also wants CMS to improve oversight of Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program, which seeks to correct issues identified through screenings, such as lead toxicity.

Also among the OIG’s requests are for CMS to issue guidance to remind State Medicaid programs of their obligations under the EPSDT program.

CMS concurred with the recommendations, the report said. The agency said it would remind states they are obligated to provide clinical guidance to providers.