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Enforcement Actions

The goal of the Office of Enforcement is to ensure compliance with the Knox-Keene Act through timely, aggressive action against health plan violations. It is also responsible for handling the litigation needs of the DMHC, representing it in actions to enforce the managed care laws.

When a health plan violates the Act, the Director is authorized to take a variety of actions. This may include assessing administrative, civil and criminal penalties. It may also include issuing a cease and desist order requiring the plan to stop the offending action. Under all of these circumstances the plans are afforded Due Process protections and given notice and a hearing to contest or defend their actions.

The Enforcement Action Database allows you to search enforcement actions which have been adjudicated since July 1, 2000. You can search by different criteria including: name of Health Plan or organization (as with Discount Health Plans), date range, penalty amount or range, document category, or violation (Health and Safety Code section and California Code of Regulations). There is also a feature which allows you to "full text search" all the documents issued by the Office of Enforcement.