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What's New

DMHC Seeks Members for Financial Solvency Standards Board

This is a readvertisement of a solicitation released in September 2020.

The Department of Managed Health Care (DMHC) is seeking five (5) dynamic and solution-oriented professional 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 December 31, 2020.

Candidates who previously submitted a Letter of Interest and required documents do not need to reapply.

Financial Solvency Standards Board Meeting

The Department of Managed Health Care (DMHC) invites you to the Financial Solvency Standards Board (FSSB) Meeting to be held on November 18, 2020, beginning at 10 a.m. The meeting will be conducted exclusively through videoconference and teleconference.

Members of the public may participate in the meeting by Zoom Video or Conference Call Number: (877) 853-5257 or (888) 475-4499 Meeting ID: 958 3382 2337, Password: 850835

For more information about this public meeting, please read the agenda or visit the Financial Solvency Standards Board Webpage.

RFP No. 20MC-SA008 – External Party Review Services

The Department of Managed Health Care (DMHC) is soliciting proposals from qualified entities for External Party Review Services to oversee the Corrective Action Plan (CAP) Process when a Risk-Bearing Organization (RBO) contracted by a health plan fails to satisfactorily meet established grading criteria. The services provided may include some or all of the following: overseeing development, implementation and completion of the CAP Process and activities explicitly described in the California Code of Regulations (CCR), Title 28, Section 1300.75.4.8. The RFP 20MC-SA008 for External Party Review Services may be viewed and downloaded from Cal eProcure at RFP 20MC-SA008 – External Party Review Services.

The Questions and Answers for this RFP may be viewed and downloaded from Cal eProcure at Questions and Answers for RFP 20MC-SA008 – External Party Review Services.

Public Hearing on Stanford Health Care Advantage Proposed Corporate Conversion

The Department of Managed Health Care (DMHC) invites you to a public hearing on the proposed corporate conversion of Stanford Health Care Advantage to be held on December 8, 2020, beginning at 1 p.m. (PST). The hearing will be conducted exclusively through videoconference and teleconference.

Members of the public may participate in the hearing by Zoom video or by calling toll-free at (877) 853-5257 / (888) 475-4499 and entering Meeting ID: 847 1866 1430 and Passcode 615758.

More information about this public hearing can be found in the public notice. For further information, visit the DMHC Public Meetings webpage. If you would like any of the documents for this public hearing in an accessible format, please send an email to do.admin.support@dmhc.ca.gov.

DMHC Reminds Health Plans of Vaccination Requirements, including the Flu Vaccine

Given the ongoing state of emergency due to the COVID-19 pandemic, the DMHC is concerned with the potential effects of the upcoming flu season on California’s population and health care system as well as a surge in other vaccine preventable illnesses, particularly in children. Now more than ever, it is imperative that all Californians receive timely and appropriate vaccinations and that barriers to coverage of and provider reimbursement for the vaccinations are lessened. The DMHC issued an All Plan Letter to remind health plans of existing requirements and to encourage health plans and their delegated entities to exercise maximum flexibility in covering and reimbursing for vaccines for enrollees.

DMHC APL 20-037 - Vaccinations; Coverage and Flexibility

Assistance for Health Plan Enrollees Impacted by Wildfires

The California Department of Managed Health Care (DMHC) requires California health plans to help victims of Natural Disasters, including wildfires, who are experiencing problems obtaining health care services. This could 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. You should first contact your health plan for assistance. If you have problems obtaining services or assistance from your health plan, you can contact DMHC’s Help Center at 1-888-466-2219 or visit www.HealthHelp.ca.gov.

DMHC APL 20-030 - State of Emergency due to Extreme Weather and Wildfires

Chief Medical Officer Job Announcement

The Department of Managed Health Care (DMHC) is seeking a dynamic, creative, collaborative and consumer-oriented contracted Clinical Consultant to serve as the DMHC’s Chief Medical Officer (CMO). CMO will assist with ensuring health plan medical, behavioral health and administrative compliance with statutory and regulatory requirements in order to drive improvement in clinical outcomes for health plan enrollees and to improve the DMHC’s effectiveness.

For more information, please read this CMO Job Announcement. Interested candidates must submit required documents by December 31, 2020.

2018 Annual Report and Infographic

The Department of Managed Health Care 2018 annual report and infographic are now available online. Both of these documents highlight the DMHC’s activities during 2018 and include key statistics about the Department.

2018 DMHC Annual Report2018 DMHC  Infographic

CDPH COVID-19 Updates

DMHC COVID-19 Updates

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