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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

Public Meeting on the Acquisition of Health Net of California by Centene

Tuesday, November 17, 2015

The Department of Managed Health Care (DMHC) invites you to a public meeting on the acquisition of Health Net of California by Centene.  Representatives from both plans will be present.  The meeting will be held in Sacramento on December 7, 2015 from 9:30 a.m. to 11:30 a.m.  The purpose of the meeting is to discuss DMHC’s jurisdiction and authority to oversee the transaction and to solicit public comment for DMHC’s consideration as it reviews the transaction.  Public comment will be limited to 3 minutes.  Comments may also be submitted to until 5:00 p.m. on December 12, 2015. More . . .

DMHC Fines Blue Shield and Anthem for Inaccurate Provider Directories

Tuesday, November 3, 2015

(Sacramento) – The California Department of Managed Health Care (DMHC) announced today that it issued a $350,000 fine against Blue Shield of California (Blue Shield) and a $250,000 fine against Anthem Blue Cross (Anthem) for inaccurate provider directories.

“An important element of access is ensuring enrollees have accurate provider directories,” said DMHC Director Shelley Rouillard. “The DMHC has taken enforcement action and fined Blue Shield and Anthem due to unacceptable inaccuracies in their directories. These inaccuracies limited enrollee access to care that resulted in an unacceptable consumer experience and must be fixed.”  More.....

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...

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  • Medical Loss Ratio


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