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MedicaidPrior AuthMedium impact

22-642m Request Authorization for Asthma Remediation

Health Net·CA · Allergy & Immunology, Pulmonology, Family Medicine +1 more·Prior Authorization
Effective date
Aug 11, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

HealthNet California now requires prior authorization for asthma remediation services, which include physical modifications made to homes to improve health, welfare and safety of people with asthma. This applies specifically to Medi-Cal members in Fresno, Kings and Madera counties.

Action Required

Action needed
Immediately: Billing team must obtain prior authorization from HealthNet California before providing asthma remediation services (home modifications) for Medi-Cal patients in Fresno, Kings and Madera counties. Update billing system to flag these services for prior auth requirement. Claims will be denied without proper authorization.