Data & Research

Providing information to the public is an important part of the consumer protection services provided by the DMHC. Search our databases and read our reports to gain a better understanding of California’s health care delivery systems.

Premium Rate Review

Financial Information

Health Plan Information

Health Plan Compliance Information

  • Medical Survey Reports - California managed care law (Knox-Keene Health Care Service Plan Act) requires the Department to conduct a routine medical survey of each licensed full service and specialty health plan at least once every three years.
  • Search Enforcement Actions - Search for enforcement actions, which have been adjudicated since July 1, 2000, in the Enforcement Action Database.
  • Timely Access Reports - Summary of health and mental health plan compliance with the timely access regulations.

Provider Related Information

  • Quarterly Claims Settlement Practices Report
    Shows providers and affiliates that did not reimburse at least 95% of claims in a timely fashion. Shown by year and quarter.
  • Provider Complaint / Dispute Issues Statistics - The Department of Managed Health Care's Provider Complaint Unit tracks and trends provider complaints submitted by California providers. The posted statistical information reflects the provider complaint activity for each calendar year quarter.

Disputes and Resolutions

  • Arbitration Decisions - Each health plan which uses arbitration to settle disputes with its members must file with the Department a copy of any written arbitration decision.
  • Independent Medical Review and Complaint Resolutions - The Department publishes an annual report that details the number and types of complaints or grievances received during the calendar year, including Independent Medical Review (IMR) data.
  • Search for Independent Medical Review cases - The IMR program was created by the California Legislature, and provides a vital service for California health plan members. In our database, you’ll find all IMR decisions since the program began on January 1, 2001.