EPSDT: Day Habilitative Services

eQ Health Solutions, the QIO-like organization for the Arkansas Department of Human Services (DHS), provides utilization and quality control over per review for both of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefits of Applied Behavior Analysis (ABA) and Day Habilitation to qualifying Arkansas Medicaid beneficiaries.  These are services require a physician’s recommendation of medical necessity.  Kid on ARKids First B are not entitled to all the extended EPSDT benefits.

 

Request for Day Habilitation Services

  1. All reviews are conducted by a Board certified Pediatrician with developmental expertise
  2. All reviews are for a maximum of 5 hours per day 5 days per week for a 12 month duration
  3. If the PA request does not contain documentation clearly establishing that the requested services are medically necessary the request will be review by a second Board certified Pediatrician who will determine whether to enter a determination that some or all of the requested care is not medically necessary (adverse decision)