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EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT SERVICES (EPSDT) - Comprehensive services states are required to provide to Medicaid-enrolled children who need them, including extensive services for children with disabilities. The Deficit Reduction Act allows states to restructure children's benefits to provide a narrower array of services for healthy children; however, states must continue to provide wrap-around EPSDT benefits. Click here for more information.

ELECTRONIC MEDICAL RECORD/ELECTRONIC HEALTH RECORD - A computer-based record containing health care information. EMRs may include clinical, demographic and/or administrative data. Also known as a computerized patient record.

EMPLOYEE RETIREMENT INCOME SECURITY ACT (ERISA) - Enacted in 1974, ERISA was primarily designed to secure workers' pension rights. The law established federal reporting and disclosure requirements for most private employee health plans. Under ERISA, companies that pay for their workers' health benefits directly (e.g. by self-insuring and assuming all or most financial risk) are exempt from state insurance regulations and taxes. ERISA also limits workers' ability to sue their insurer. Click here for more information.

EMPLOYER CONTRIBUTION REQUIREMENT OR "EMPLOYER MANDATE" - A requirement that employers either provide health care benefits to their workers or pay a fee that contributes to the cost of covering their workers under a public (state) plan. Such proposals are also called "pay or play."

EMPLOYER MANDATE - A state or federal mandate that requires specified employers to provide health insurance benefits to their employees. A related alternative approach is to require employers to either “play” by providing health benefits to their employees or “pay” to the state or federal government so that these entities can pay for benefits.

EMPLOYER-SPONSORED INSURANCE (ESI) - A voluntary system in which employers choose to provide health insurance for employees.

END-STAGE RENAL DISEASE (ESRD)- Kidney disease that is severe enough to require lifetime dialysis or a kidney transplant. People of all ages who have ESRD are eligible for Medicare.

ENTERPRISE LIABILITY - Proposal to hold hospitals or health maintenance organizations liable for negligent harm in medical malpractice cases, rather than holding individual physicians liable.

EVIDENCE-BASED MEDICINE- The use of current best clinical evidence in making decisions about the care of individual patients, often with the assistance of information technology. Patient preferences are considered along with clinical expertise.

EXPERIENCE RATING - Process of determining insurance premiums for a group that is based wholly or partially on that particular group's past use of services and expenses incurred. Contrast with Community Rating.

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