Department of Managed Healthcare Fines Two Health Plans $8.5 Million for Failure to Timely Respond to Health Providers’ Payment Disputes

 By Zoe Bulls In an enforcement action against two health plans, the California Department of Managed Healthcare (DMHC) fined Blue Cross of California Partnership Plan, Inc. and Blue Cross of California (Anthem Blue Cross) a combined $8.5 million for violating Continue reading

Department of Managed Healthcare Levies $250,000 Against Blue Shield of California for Illegal Billing of Contraceptive Services

By Zoe Bulls On August 28th, 2024, the California Department of Managed Healthcare (DMHC) countersigned a Letter of Agreement with California Physicians’ Service (Blue Shield of California) that notified the health plan provider of a $250,000 fine for billing 335 Continue reading

Department of Managed Healthcare Proposes Rulemaking Action on Annual, Quarterly, and Monthly Financial Reporting Requirements

By Yusra Serhan On December 24, 2021, the Department of Managed Health Care (DMHC) published notice of its intent to adopt Rule 1300.84.03; amend and renumber Rules 1300.84.06; amendment to Rules 1300.84.2 and 1300.84.3; and renumber Rules 1300.84.06 to 1300.84.1, Continue reading

Department of Managed Health Care’s Health Equity and Quality Committee Convenes its First Meeting

By Hunter W. Collins On February 24, 2022, the Department of Managed Health Care’s (DMHC) Health Equity and Quality Committee (Committee) held its first meeting via Zoom. AB 133 (Committee on Budget) (Chapter 143, Statutes of 2021), which became effective Continue reading

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 Issues Prescription Drug Cost Transparency Report for Measurement Year 2020

By Hunter W. Collins On December 27, 2021, the Department of Managed Health Care (DMHC) released its Prescription Drug Cost Transparency Report for Measurement Year 2020. Pursuant to SB 17 (Hernandez) (Chapter 603, Statutes of 2017), Health and Safety Code 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

SB 65 Becomes Law, Requiring Investigation into Serious Illness and Deaths Associated with Pregnancy and Childbirth to Reduce Racial Disparities

By Hunter W. Collins SB 65 (Skinner), the “California Momnibus Act,” as amended September 2, 2021, adds section 123660, adds Article 4.7 (commencing with section 123635), and adds Article 4 (commencing with section 128295) to the Health and Safety Code Continue reading