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L.A. Care Health PlanMedicaid · Documentation · Provider Communication · CA · Family Medicine, Internal Medicine, PediatricsMedium impact

2026 Annual Training Initial Health Appointments (IHAs) Presentation

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

Direct Network providers must complete each member's Initial Health Appointment (IHA) within 120 calendar days of enrollment, perform it in the primary care setting in a culturally and linguistically appropriate way, and document it in the member's medical record. For members under 18 months, an IHA must include a history of the member's physical and mental health, an identification of risks, an assessment of need for preventive screens or services, health education, and the diagnosis and plan for treatment of any diseases. Members under 21 also require EPSDT screenings, and age-appropriate IHAs must include a completed blood lead screening or documented evidence of refusal.

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What to do

Action · 12 steps
01Providers: complete each member's IHA within 120 calendar days of enrollment.
02An IHA is not required when all elements were completed and documented within the prior 12 months (a new provider must still review and update it).
03Documented exceptions are: the member refuses, which must be documented with encouragement to contact L.A.
04Care for provider reassignment; the member misses a scheduled IHA and at least one documented reschedule attempt is unsuccessful; or the member has not scheduled the initial IHA after two unsuccessful outreach attempts.
05If a member is hospitalized during the 120-day period, provide the H&P and post-discharge office visit notes.
06Where risks are identified, document evidence of follow-up within 60 days.
07Document each outreach attempt, successful or not, with date, method, reason and outcome, and keep records in a centralized system.
08For members under 21, document EPSDT screenings, dental screening, immunizations, and blood lead screening or refusal, with anticipatory guidance on lead exposure until 72 months of age.
09Quarterly case reviews require supporting documentation within two weeks of the request.
10Non-compliance in one quarter brings a Compliance Deficiency Notice on the scorecard; a second consecutive quarter brings a Compliance Deficiency Notice letter and a request for a corrective action plan; a third consecutive quarter escalates to the Delegation Oversight Committee, with possible sanctions.
11Return the signed training attestation form by the due date to Compliance_DOCommunications@lacare.org.
12Confirm current applicability of this January 2026 training before acting.

Original notice

2026 Annual Training Initial Health Appointments (IHAs) Presentation
lacare.org · Always check the source before changing claims.
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L.A. Care Health Plan policiesCA policy changesFamily MedicineInternal MedicinePediatrics

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