Childhood Lead Screening – A 2021 HEDIS Measure

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Date: August 13, 2021
To: Health Plan of San Joaquin (HPSJ) Contracted Providers
From: Health Plan of San Joaquin
Subject: Childhood Lead Screening – A 2021 HEDIS Measure
Business: Medi-Cal

In 2021, you will receive quarterly communications from Health Plan of San Joaquin when HPSJ members are out of compliance for blood lead screening. This list is in addition to the “HEDIS Measures Gap in Care” reports available to you for your HPSJ patients within our secure DRE provider portal.

Children covered by Medi-Cal are required by the federal Centers for Medicare and Medicaid Services (CMS) to receive blood lead screening tests:

  • At both 12 months of age and 24 months of age
  • Or, between 24 months and 72 months, if there is no record of a previous blood lead screening, they should receive at least one test

All providers who perform periodic health screenings on members between the ages of six months to six years (i.e., 72 months) must comply with current federal and state laws, and industry guidelines for health care providers issued by the California Department of Public Health’s (CDPH) Childhood Lead Poisoning Prevention Branch (CLPPB).

Anticipatory Guidance
Doctors must discuss and document at a minimum: Children can be harmed by exposure to lead, especially deteriorating or disturbed lead-based paint and dust from it and are particularly at risk of lead poisoning.

Blood Lead Screening
Medical record documentation should include evidence of patient referral for screenings including any parent/guardian refusals for screenings. All blood lead screening results should be clearly documented with date of service and screening results.

For more information on blood lead screenings visit the CDPH website at
https://www.cdph.ca.gov.

If you have questions, please contact Provider Services at 1.888.936.PLAN (7526).

Your practice may qualify for additional VBP/Prop 56 reimbursement.
For more information visit our website at: https://www.hpsj.com/value-based-payments/

Posted on August 13th, 2021 and last modified on August 13th, 2021.

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