Monday, December 15, 2025
DMHC fines three Centene-owned plans $1.7 million for failing to meet appointment timely access standards
SACRAMENTO - The Department of Managed Health Care (DMHC) today announced enforcement actions against three plans owned by Centene Corporation (Centene), including a total of $1.7 million in fines for failing to comply with reporting rates for appointment timely access standards. The DMHC fined Health Net of California, Inc. $1.2 million, Human Affairs International of California (HAI-CA) $300,000 and Health Net Community Solutions, Inc. $200,000.
“Ensuring health plan members have timely access to the health care they need is a top priority for the DMHC,” said DMHC Director Mary Watanabe. “Delays in finding timely appointments can be a barrier for patients seeking medically necessary care, and can have negative impacts on health plan members.”
PROTECTIONS FOR HEALTH PLAN MEMBERS: Health plan members have the right to timely health care appointments under the law. Health plans must ensure their network of providers, including doctors, can provide members an appointment within specific timeframes. In addition, plans must offer primary care providers within 15 miles or 30 minutes from where health plan members live or work.
BACKGROUND: Health plans conduct annual surveys of their provider networks to assess compliance with the state’s timely access to care standards. Plans report the results of the surveys to the DMHC. In this case, all three plans failed to report minimum rates of compliance with timely access standards for certain provider networks.
WHAT CAN HEALTH PLAN MEMBERS DO: If a health plan member is not able to get an appointment within the timely access standard, they should first contact their health plan for assistance. If the problem continues, they should contact the DMHC Help Center at www.DMHC.ca.gov or 1-888-466-2219.
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About DMHC
The mission of the DMHC is to ensure health plan members have access to equitable, high-quality, timely, and affordable health care within a stable health care delivery system. The DMHC accomplishes this important mission by regulating health plans, enforcing California’s strong consumer protection laws and assisting health plan members. For more information visit www.DMHC.ca.gov.