Understanding the Interaction Between EPSDT and Federal Health Information Privacy and Confidentiality Laws
This paper examines the federal and state law underpinnings of access to patient health records across health care providers and settings of care for Medicaid-enrolled children, who are entitled to Early and Periodic Screening Diagnostic and Treatment (EPSDT). This analysis sets forth the relevant laws of the HIPAA Privacy Rule, the Family Educational Rights and Privacy Act (FERPA), and 42 C.F.R. Part 2, that affect the relationships of the health care professionals, minor children, and legal guardians as well as the relationships among health care, educational, and social services providers. Finally, this paper provides examples of information exchange and management issues that may occur in the treatment of Medicaid-enrolled children.