As other states have created obstacles and restricted access to reproductive health care, the California Department of Managed Health Care (DMHC) issued guidance reminding health plans regulated by the Department of requirements to cover and provide access to emergency and urgent care services when enrollees are out of state. This …continue reading
The California Department of Managed Health Care (DMHC) is continuing to monitor access to services for Californians enrolled in Kaiser Foundation Health Plan, Inc. (Kaiser Permanente) who may be impacted during a strike by behavioral health care workers in Northern California. “Ensuring California health plans provide timely access to care …continue reading
The California Department of Managed Health Care (DMHC) and Department of Health Care Services (DHCS) have taken action against Local Initiative Health Authority for Los Angeles County (L.A. Care) to protect the plan’s members. The two departments’ actions against the state’s largest Medi-Cal plan include penalties of $55 million. This …continue reading
The California Department of Managed Health Care (DMHC) announces approving Centene Corporation’s (Centene) acquisition of Magellan Health, Inc. (Magellan) with conditions to ensure the merger does not adversely impact enrollees or the stability of California’s health care delivery system. “Our review of Centene’s acquisition of Magellan focused on ensuring compliance …continue reading
The California Department of Managed Health Care (DMHC) today issued guidance to ensure health plans comply with amendments made to California’s mental health parity law enacted under Senate Bill (SB) 855, authored by Senator Scott Wiener (D-San Francisco) and signed by Governor Gavin Newsom last year. “The DMHC is committed …continue reading
The California Department of Managed Health Care (DMHC) today released the Prescription Drug Cost Transparency Report for Measurement Year 2019. The report looks at the impact of the cost of prescription drugs on health plan premiums and compares this data over three reporting years: 2017, 2018, and 2019. Among other …continue reading
The California Department of Managed Health Care (DMHC) today directed health plans regulated by the Department to remove administrative burdens on hospitals during the COVID-19 surge. This includes directing plans to take immediate steps to reduce or remove unnecessary barriers to the efficient admission, transfer, and/or discharge of health plan …continue reading
The California Department of Managed Health Care (DMHC) issued guidance reminding health plans that all qualified, approved COVID-19 vaccines must be provided with no cost-sharing for health plan enrollees, regardless of whether the enrollee receives the vaccine from an in-network or out-of-network provider. “As we begin to enter this new …continue reading
This is a readvertisement of a solicitation released in September 2020. The Department of Managed Health Care (DMHC) is seeking five (5) dynamic and solution-oriented professional to serve on the Financial Solvency Standards Board (FSSB). The FSSB is a statutorily created entity that meets quarterly to advise the DMHC Director …continue reading
The California Department of Managed Health Care (DMHC) has taken enforcement action including $1,205,000 in fines against Blue Cross of California Partnership Plan, Inc. (Blue Cross) for its failure to timely implement two Independent Medical Review (IMR) determinations to authorize coverage for medically necessary services. The Medi-Cal managed care plan …continue reading
The California Department of Managed Health Care (DMHC) released the Prescription Drug Cost Transparency Report for Measurement Year 2018. The report looks at the impact of the cost of prescription drugs on health plan premiums and compares this data from the first two reporting years of 2017 and 2018. Among …continue reading