Department of Managed Health Care and Department of Health Care Services Issue $55 Million in fines to L.A. Care Health Plan in Enforcement Action to Protect Consumers

By William Espinosa On March 4, 2022, the Department of Managed Health Care (DMHC) released a statement detailing its enforcement action against Local Initiative Health Authority for Los Angeles County (L.A. Care), the state’s largest Medi-Cal plan. The action is Continue reading

Department of Managed Health Care Approves Centene Acquisition of Magellan Health

By William Espinosa On December 30, 2021, the Department of Managed Health Care (DMHC) announced that it had approved Centene Corporation’s acquisition of Magellan Health, Inc. (Magellan), with certain conditions. Magellan is the parent entity for two DMHC-licensed plans: Human Continue reading

Department of Managed Healthcare Issues an All Plan Letter Reminding Health Plans of Their Obligation to Cover Influenza Vaccines and Prepare to Provide COVID Vaccines for Children Aged 5–11

By Yusra Serhan On November 1, 2021, the Department of Managed Health Care (DMHC) issued an All Plan Letter to all full-service health care service plans regarding health care coverage of the influenza vaccines and COVID-19 vaccines for children aged Continue reading

Department of Managed Health Care Provides Independent Analysis of the Competitive Effects of Centene’s Proposed Acquisition of Magellan Health

By William Espinosa On October 12, 2021, Deborah Haas Wilson, PH.D., who was retained by the Office of the California Attorney General on behalf of DMHC, published her independent analysis of the anti-competitive impact on subscribers and enrollees of a Continue reading

Department of Managed Health Care Issues Enforcement Action Against Blue Cross of California

By Meena Kaypour On February 26, 2021, the Office of Enforcement within the Department of Managed Health Care (DMHC) concluded its investigation of Blue Cross of California concerning the Plan’s violations of the Knox-Keene Health Care Service Plan Act of Continue reading

Department of Managed Health Care Orders Aetna To Pay Fine for Improper Denial Of Reconstructive Surgery

By Alex Ruf On February 25, 2021, the Department of Managed Healthcare’s (DMHC) Office of Enforcement signed a letter of agreement with Aetna Health of California, Inc. (Aetna) with respect to Aetna’s violations of Health and Safety Code sections 1367.63(a) Continue reading

Department of Managed Health Care Orders Aetna to Pay Fine for Improper Denial of Emergency Room Claims

By Meena Kaypour On August 25, 2020, the Department of Managed Health Care (DMHC) issued a cease and desist order to Aetna Health of California, Inc. with respect to its continued failure to comply with California standards for emergency room Continue reading