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Laws & Regulations

The Department of Managed Health Care administers and evaluates healthcare laws and regulations. The following sections outline these laws, including The Knox-Keene Health Care Service Plan Act, regulations, and issues.

 

You will find additional topics relating to DMHC jurisdiction, administrative actions and opportunities for public participation in rulemaking proceedings.

Knox-Keene Health Care Service Plan Act of 1975

These are the laws administered by the Department.

The Knox-Keene Health Care Service Plan Act of 1975, as amended, is the set of laws or statutes passed by the State Legislature to regulate health care service plans, including health maintenance organizations (HMOs)  within the State. The Knox-Keene Act is in the California Health & Safety Code, section 1340 et seq.

In addition to statutes, the DMHC develops regulations with the help of our stakeholders: consumers, health plans, and providers, pursuant to the Administrative Procedures Act.   These regulations are codified under title 28 of the California Code of Regulations. Regulations are used by the DMHC to implement, interpret, or make specific the laws enforced by the Department.

Newly Effective Regulations

These regulations were adopted after February, 2016.

Regulations become effective 30 days after filing with the Secretary of State. The text of the regulation is available within each regulation.

View Newly Effective Regulations

Open Pending Regulations

These are the draft regulations in which the Department is asking for public comments on.

View Open Pending Regulations

Closed Pending Regulations

These are the draft regulation in which the comment period is closed. The Department is now reviewing the comments.

View Closed Pending Regulations

Approved Pending Regulations

The formal rulemaking process is completed. These regulations will become law.

Approved Pending Regulations

Issues and Regulations

This section lists the topics the Department is currently considering and evaluating and where you can submit comments on those topics.

Issues and Regulations for the Upcoming Year

Additional information about this website and the Office of Legal Services role in the rulemaking process is available by clicking the following link: Office of Legal Services Information

The laws by which the Department regulates health plans come in two varieties: those statutes enacted by the Legislature and those regulations developed by the Department. The California Legislature has enacted a body of statutes collectively known as the Knox-Keene Health Care Service Plan Act of 1975, as amended.