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DMHC Regulates Health Plans and Helps Health Plan Members and Providers

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Californians have the strongest patient's rights laws in the nation. DMHC’s Help Center is available to explain your health care rights and help you understand how to use your health care benefits. The Help Center can also resolve problems you may have with your health plan.

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Ensuring prompt and fair payment of health care providers is critical to the stability of California's health care delivery system.  The DMHC’s Provider Complaint Unit can assist California physicians; hospitals and other licensed health care providers resolve disputed claim issues with payers.

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The DMHC licenses and regulates California health plans and strives to streamline the process health plans must follow to comply with the law. This section has all the information and forms plans need to ensure compliance.

What's New

Department of Managed Health Care Approves Blue Shield Acquisition of Care 1st

Thursday, October 8, 2015

$200 Million Investment to Help Consumers, Make Health Care More Transparent & Accessible


(Sacramento) – California Department of Managed Health Care (DMHC) Director Shelley Rouillard has issued an order approving Blue Shield of California’s (Blue Shield) acquisition of Care1st Health Plan (Care 1st).


“This order brings Blue Shield into the Medi-Cal program and requires the plan to improve quality and access for Medi-Cal beneficiaries.  Prior to approval, my team performed an exhaustive review of all aspects of the proposed transaction, performed complex legal analyses, conferred with external experts and considered all public comments,” said Director Rouillard.  More....

Department of Managed Health Care Strategic Plan 2015 - 2019

Tuesday, September 1, 2015

The Department of Managed Health Care has announced its five-year strategic plan. The strategic plan includes a new mission statement, as well as the core values, goals, objectives and strategies for accomplishing the Department’s mission. This plan was developed with input from DMHC staff and external stakeholders.  More...

Department of Managed Health Care Joins California Health and Human Services Open Data Portal

Tuesday, May 26, 2015

The Department of Managed Health Care (DMHC) posted initial datasets on the California Health and Human Services (CHHS) Open Data Portal. The initial data sets include enforcement actions taken by the DMHC, Independent Medical Review (IMR) decisions, and premium rates filed with the DMHC.


CHHS launched its Open Data Portal initiative in order to increase public access to one of the State’s most valuable assets – non-confidential health and human services data. Its goals are to spark innovation, promote research and economic opportunities, engage public participation in government, increase transparency, and inform decision-making.


Visit the Open Data Portal here:


Learn About...

  • DMHC
  • Rate Review
  • Consumer Assistance
  • Independent Medical Review (IMR)
  • Medical Loss Ratio