DMHC Seeks Members for Financial Solvency Standards Board
The Department of Managed Health Care (DMHC) is seeking dynamic and solution-oriented professionals to serve on the Financial Solvency Standards Board (FSSB).
For more information, please read the Board Member Solicitation and Job Description. Interested candidates must submit required documents by October 15, 2021.
Health Equity and Quality Committee Solicitation
The Department of Managed Health Care (DMHC) is seeking dynamic and solution-oriented health care professionals and advocates to serve on the DMHC Health Equity and Quality Committee.
The Committee will provide initial recommendations to the DMHC Director for standard health equity and quality measures, including annual benchmark standards for assessing equity and quality in health care delivery.
Individuals with training and experience in health care quality, quality improvement activities, health equity, social determinants of health, and/or health disparities are encouraged to apply. In order for the Committee composition to reflect the diversity of the State of California, the Department is seeking individuals who represent and have knowledge of diverse communities, including the racial, cultural, ethnic, sexual orientation, gender, economic, linguistic, age, disability, and geographical diversity of California.
For more information, please read the Committee Member Solicitation and Committee Overview. Interested candidates must submit required documents by October 15, 2021.
Health Plan Assistance for Enrollees Displaced by Wildfires
Health plans must ensure enrollees displaced by natural disasters, including wildfires, continue to have appropriate access to medically necessary health care services.
Department of Managed Health Care (DMHC) licensed health plans must help victims of Natural Disasters, including wildfires. Help can include speeding up approvals for care, replacing lost prescriptions and ID cards, or quickly arranging health care at other facilities if a hospital or doctor's office is not available due to the disaster. For more information, read the fact sheet on natural disasters.
DMHC APL on Continued Coverage of COVID-19 Diagnostic Testing
The DMHC issued an All Plan Letter (APL) reminding health plans that federal law continues to require them to cover COVID-19 testing for their enrollees when the testing provides an individualized assessment of whether the enrollee has a COVID-19 infection. Health plans must cover the testing whether it is performed in or out of network and may impose no prior authorization or cost-sharing requirements on such testing. Health plans must cover the testing whether the person is symptomatic or asymptomatic and regardless of whether the person has had recent known or suspected exposure to COVID-19.
DMHC APL 21-020 – Continued Coverage of COVID-19 Diagnostic Testing
DMHC Celebrates 20 Years of Consumer Protection in 2020 Annual Report
In 2020, the Department of Managed Health Care (DMHC) celebrated the 20-year anniversary of the creation of the Department. The DMHC also celebrated the 45th anniversary of the Knox-Keene Act and the 10th anniversary of the Affordable Care Act (ACA). The 2020 Annual Report celebrates these significant anniversaries and highlights many of the important achievements in health care and consumer protection over the past 20 years.
DMHC Finds Acquisition of HAI-CA and MHSC’s indirect parent, Magellan Health, Inc. (Magellan) by Centene, Inc. (Centene) to be a “Major Transaction or Agreement”
The DMHC finds the acquisition of Human Affairs International of California (HAI-CA) and Magellan Health Services of California, Inc. – Employer Services (MHSC) and MHSC’s indirect parent, Magellan Health, Inc. (Magellan) by Centene, Inc. (Centene) to be a “major transaction or agreement” under Health and Safety Code section 1399.65. Upon due consideration, the Department determined that the specific facts of this change of control meet criteria set out in Section 1399.65, subdivision (g)(1). Accordingly, the change of control proposed through the Notices is a major transaction or agreement, and a public meeting and independent analysis is required as set forth in Section 1399.65, subdivisions (a)(4) and (c).
DMHC Takes Action to Ensure Health Plans Comply with California's Mental Health and Substance Use Parity Law
The California Department of Managed Health Care (DMHC) today issued guidance to ensure health plans comply with amendments made to California's mental health parity law enacted under Senate Bill (SB) 855, authored by Senator Scott Wiener and signed by Governor Gavin Newsom last year.
"The DMHC is committed to ensuring Californians can access quality mental health and substance use disorder services. This is especially critical right now as people are dealing with the COVID-19 pandemic that has no doubt had an impact on the mental health of many," said DMHC Director Mary Watanabe. "This new law strengthens California's mental health parity statute and will help improve access to quality mental health and substance use disorder services."
Press Release
DMHC APL 21-002 - SB 855, Mental Health and Substance Use Disorder Coverage
DMHC Directs Health Plans to Cover COVID-19 Vaccines with No Cost-Sharing to Enrollees
The California Department of Managed Health Care (DMHC) issued guidance reminding health plans that all qualified, approved COVID-19 vaccines must be provided with no cost-sharing for health plan enrollees, regardless of whether the enrollee receives the vaccine from an in-network or out-of-network provider.
"As we begin to enter this new phase of the pandemic with vaccines becoming available, the DMHC is reminding health plans they must cover the cost of COVID-19 vaccines," said DMHC Director Mary Watanabe. "It is critical that all Californians have access to a safe COVID-19 vaccine to help protect their health. Financial challenges should not and will not get in the way of getting protection from COVID-19."
Press Release
Fact Sheet
DMHC APL 20-039 – Health Plan Coverage of COVID-19 Vaccines