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Use the health plan dashboard to view or compare health plan information. The health plan dashboard features health plan contact information, enrollment data, complaint and IMR data, enforcement actions, and financial data.

Select a health plan by using the search window above or choose from a list of all plans.

View the DMHC Dashboard for a comprehensive look at DMHC health plan data.

What's New

Guidance Relating to Non-Discrimination in Medical Treatment for Novel Coronavirus 2019 (COVID-19)

The Departments of Health Care Services (DHCS), Public Health (CDPH), and Managed Health Care (DMHC) continue to closely monitor and assess appropriate next steps as well as release guidance to ensure the safety of Medi-Cal beneficiaries, health plan enrollees, medical providers, and California communities in general.

The State of California understands that people with disabilities are concerned that medical providers might consider an individual’s disability status when determining which patients to treat if hospitals or other health care facilities experience a surge of patients needing life-saving care. This joint bulletin reminds health care providers and payers that rationing care based on a person’s disability status is impermissible and unlawful under both federal and state law.

DMHC Expands Special Enrollment Period in Response to COVID-19

As the state of California is taking action to respond to the COVID-19 pandemic, the Department of Managed Health Care (DMHC) joined with Covered California and the Department of Health Care Services to make sure Californians have a ready path to health care coverage.

The DMHC provided guidance to health plans on the special-enrollment period, including on and off-exchange health plans. This will ensure consumers enrolling in the entire individual market in California will have access to coverage during the pandemic emergency.

“We are working together to protect the health and safety of Californians during this pandemic,” said DMHC Director Shelley Rouillard. “This includes making sure that Californians are able to access health care coverage. Opening a special-enrollment period due to COVID-19 offers new coverage options to Californians when they need it most.”

DMHC All Plan Letter

DMHC Directs Health Plans to Ensure Californians Can Access Necessary Medical Care Through Telehealth

The DMHC directed health plans to ensure Californians can access necessary medical care through telehealth when medically appropriate. This includes directing health plans to reimburse providers for care provided through telehealth at the same rate as in-person care and ensuring enrollee cost-sharing is not changed for telehealth services.

DMHC All Plan Letter

DMHC Encourages Health Plans Practice “Social Distancing” Measures in Response to COVID-19.

The Department of Managed Health Care (DMHC) issued an All Plan Letter encouraging health plans take actions to facilitate the delivery of health care services in a manner that decreases the need for in-person visits and practices “social distancing” measures to help slow the spread of COVID-19. This includes expanding health care delivery via telehealth and decreasing the need for in-person pharmacy visits.

DMHC All Plan Letter

Health Care Coverage Options

If you do not have a source of health care coverage or have recently lost your employer-sponsored health care coverage, this fact sheet provides and an explanation of some options to gain health care coverage. Contact the specific programs for more information.

Coverage Options Fact Sheet in English

Coverage Options Fact Sheet in Spanish

Chief Medical Officer Job Announcement

The Department of Managed Health Care (DMHC) is seeking a dynamic, creative, collaborative and consumer-oriented contracted Clinical Consultant to serve as the DMHC’s Chief Medical Officer (CMO). The CMO will assist with ensuring health plan medical, behavioral health and administrative compliance with statutory and regulatory requirements in order to drive improvement in clinical outcomes for health plan enrollees and to improve the DMHC’s effectiveness.

For more information, please read this CMO Job Announcement. Interested candidates must submit required documents by May 8, 2020.

DMHC Directs Health Plans to Waive Cost-Sharing for COVID-19 Testing

Under the direction of Governor Gavin Newsom, the Department of Managed Health Care (DMHC) issued an All Plan Letter directing all full-service commercial and Medi-Cal plans regulated by the Department to immediately reduce cost-sharing to zero for all medically necessary screening and testing for the novel coronavirus (COVID-19). This includes waiving cost-sharing for emergency room, urgent care or provider office visits when the purpose of the visit is to be screened and tested for COVID-19. The need for COVID-19 testing is based on medical necessity, a clinical determination made on a case by case basis by medical professionals.

DMHC All Plan Letter

CDPH Press Release

RFP No. 19MC-SA021 – Methodologies Assessment and Development

The Department of Managed Health Care (DMHC) is soliciting proposals from qualified entities to provide expert advice, formal recommendations, supporting documentation and tools to assess current file review methodologies and if applicable, develop and implement a revised or new statistically valid file review methodology. The RFP 19MC-SA021 for Methodologies Assessment and Development may be viewed and downloaded from Cal eProcure at RFP 19MC-SA021 - Methodologies Assessment and Development.

The Questions and Answers for this RFP may be viewed and downloaded from Cal eProcure at Questions and Answers for RFP 19MC-SA021 – Methodologies Assessment and Development.

Assistance for Patients Impacted by the AKF Leaving California

The American Kidney Fund (AKF) has announced it is ending financial assistance funds for Californians in need. The following fact sheet includes information on alternative options patients can explore and how to get help with these other health coverage options.

English Fact Sheet

Spanish Fact Sheet

2018 Annual Report and Infographic

The Department of Managed Health Care 2018 annual report and infographic are now available online. Both of these documents highlight the DMHC’s activities during 2018 and include key statistics about the Department.

2018 DMHC Annual Report2018 DMHC  Infographic

CDPH COVID-19 Updates

DMHC COVID-19 Updates

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