The people of the Department of Managed Health Care work toward an affordable, accountable and robust managed care delivery system that promotes healthier Californians.
Through leadership and partnership, the Department shares responsibility with everyone in managed care to ensure high quality health care, as well as cost-effective regulatory oversight. The Department achieves this mission by:
- Administering and enforcing the body of statutes collectively known as the Knox-Keene Health Care Service Plan Act of 1975, as amended.
- Operating the 24-hour-a-day Help Center to resolve consumer complaints and problems.
- Licensing and overseeing all Health Maintenance Organizations (HMOs) and some Preferred Provider Organizations (PPOs) in the state. Overall, the DMHC regulates approximately 90 percent of the commercial health care marketplace in California, including oversight of enrollees in Medi-Cal managed care health plans.
- Conducting medical surveys and financial examinations to ensure health care service plans are complying with the laws and are financially solvent to serve their enrollees.
- Convening the Financial Solvency Standards Board, comprised of people with expertise in the medical, financial and health plan industries. The board advises the Director on ways to keep the managed care industry financially healthy and available for the more than 21 million Californians who are currently enrolled in these types of health plans.