Medicaid programs in 9 states failed to verify whether 41% of the children in the programs had received any of the required health screenings during a 1-year study period.

Investigators in the Office of the Inspector General for the U.S. Department of Health and Human Services looked at 9 states’ compliance with the Medicaid Early and Periodic Screening, Diagnostic and Treatment screening schedule.

The states included in the study were Arkansas, Florida, Idaho, Illinois, Missouri, North Carolina, Texas, Vermont and West Virginia.

HHS inspector general’s office staffers looked at records for 345 children enrolled in Medicaid in the states in 2007.

The record review suggests that 76% of the children eligible for the screenings may have missed at least one required medical, vision or hearing screening in the previous year, and that 41% of the children had no records of receiving any of the required screenings.

Fewer than half of the children received the required vision and hearing screenings.

The medical screening requirement includes a laboratory test requirement. The records of 38% of the children who received medical screenings lacked documentation that the children had received the required lab tests, officials write.

Earlier studies found, for example, that only 15% of the children under age 5 had received the required blood lead screenings, officials write.

Medicaid program administrators told the investigators that barriers to improving screening rates include some a belief that the screenings are not necessary; a belief that children should go to the doctor only when sick; and concerns about taking time off for work.

“Other barriers cited include limited access to providers, incorrect beneficiary contact information, and failure of beneficiaries to keep appointments,” officials write.

The investigators are recommending that the Centers for Medicare and Medicaid Services, the HHS arm responsible for overseeing Medicaid, work with states and care providers to develop incentives for providers to complete medical screenings.