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Since 1997, the “free care” rule has stated that Medicaid will not pay for services that are offered to the general public free of charge. The rule has stood as a significant barrier for schools to receive Medicaid reimbursement for health services provided to students enrolled in Medicaid. On December 15, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a letter to State Medicaid Directors informing them of a decision to withdraw prior regulatory guidance on the free care rule. The following Q&A explains how this important reversal of Medicaid policy will impact coverage of school-based interventions for low-income children with asthma.

The prevalence of childhood asthma in the United States increased from 8.7% in 2001 to 9.5% in 2011. This increased prevalence adds to the costs incurred by state Medicaid programs. We provide state-based cost estimates of pediatric asthma emergency department (ED) visits and highlight an opportunity for states to reduce these costs through a recently changed Centers for Medicare and Medicaid Services (CMS) regulation.

Although secondhand smoke (SHS) exposure in the United States dropped by half between 1999-2000 and 2011-2012, one in four nonsmokers -- 58 million people -- are still exposed to SHS, according to a new Vital Signs report from the Centers for Disease Control and Prevention.

Explore how our initiative to combat childhood asthma made a difference in our region, and how it lives on today.

This report, prepared by the Environmental Law Institute and the Children’s Environmental Health Network, provides an overview of how state policy addresses indoor environmental exposures in the child care setting. The report describes the state of state policy today and highlights notable examples to assist policymakers, agency officials, non-governmental organizations and associations, and others who work to advance quality child care and promote children’s health.

A new study challenges the widely held belief that inner-city children have a higher risk of asthma simply because of where they live. Race, ethnicity and income have much stronger effects on asthma risk than where children live, the Johns Hopkins Children's Center researchers reported. The investigators looked at more than 23,000 children, aged 6 to 17, across the United States and found that asthma rates were 13 percent among inner-city children and 11 percent among those in suburban or rural areas.
But that small difference vanished once other variables were factored in, according to the study published online Jan. 20 in the Journal of Allergy and Clinical Immunology.
Poverty increased the risk of asthma, as did being from certain racial/ethnic groups. Asthma rates were 20 percent for Puerto Ricans, 17 percent for blacks, 10 percent for whites, 9 percent for other Hispanics, and 8 percent for Asians, the study found.

This document provides codes used to bill Medicaid within states for asthma care services, including descriptions of services covered. The information can be used to advocate for expanded Medicaid and private payer reimbursement in your state.

As CHWs become a more significant part of the healthcare workforce, states have taken a variety of approaches to supporting and regulating this group. This report by Harvard Law School's Center for Health Law & Policy Innovation is designed to review some of the major policies in different states and highlight some of the issues that arise in these programs. There is no single right approach. With sufficient stakeholder engagement, each state can develop policies tailored for its community.

Different types of data analysis tell different stories about asthma disparities in children. This study analyzed trends in racial disparities using both traditional population-based rates and at-risk rates. Population-based data methods found disparities in asthma prevalence among black children over time and asthma-related deaths increased. However, the at-risk analysis found the same racial disparities remained the same or decreased, suggesting that despite a growing asthma prevalence among black children compared to white children, progress has been made in addressing racial disparities in asthma outcomes.

This tool kit shows how Washington State partners are approaching asthma home visits.