All health care service plans must receive a license from the Department of Managed Health Care (DMHC) in order to operate in the state of California. To become licensed, a health care service plan must establish that it is in compliance with rules relating to health care service plan operations and businesses practices as set forth in the Knox-Keene Act.
Some areas of regulation require health care service plans to regularly report on operational measures to ensure ongoing compliance with the Act. The DMHC strives to streamline the process plans must follow to comply with California law. This section provides information for plans regarding how to obtain a license and how to comply with the ongoing reporting requirements necessary to maintain a license with the DMHC. This section also contains links to reports compiled by the DMHC and the results of medical surveys conducted by the DMHC which serve to educate the public about plan compliance.