Starting in January, California’s Medicaid managed care organizations will be able to use Medicaid funding to pay for home trigger remediation for people with poorly controlled asthma!
This financing win in support of a key component of asthma home visits comes under the auspices of CalAIM, a Medi-Cal reform effort. Specifically, as part of the In Lieu of Services (ILOS) program, the state allows managed care plans to provide certain services that aren’t covered by Medicaid in place of traditional health care interventions.
Asthma trigger remediation is now on the list of approved services under ILOS. Managed care organizations (MCOs) can opt to start providing these services as early as January (and MCOs can update their ILOS selections every 6 months thereafter). Of course, we hope many MCOs will choose to partner with the range of asthma home visiting programs already on the ground in California.
As is typical with these policy wins, this was a collective effort involving many other asthma stakeholders, including the California Pan Ethnic Health Network, Children Now and dozens of other committed advocates who shared their time, expertise and advocacy.
There’s more to do, of course. RAMP and our partners continue to push Medi-Cal to cover in-home asthma education provided by non-licensed professionals. But in the meantime, we should pause to celebrate our collective win!
Warm regards,
RAMP staff
