MedicaidPrior AuthLow impact
22-640m Request Authorization for Asthma Remediation
Health Net·CA · Pulmonology, Allergy & Immunology, Family Medicine +2 more·Prior Authorization
We identified it
Jun 20, 2026
Summary
Health Net California now requires prior authorization for asthma remediation services involving physical modifications to homes for Medi-Cal members. This applies to physicians, hospitals, and other participating providers in 9 specified California counties.
Action Required
Immediately: Billing team and providers must obtain prior authorization before providing or billing for asthma remediation services involving home modifications for Medi-Cal members in Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties. Update prior authorization checklists to include asthma remediation services. Claims will likely be denied without proper authorization.