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  • California Department of Managed Health Care
    The mission of the Department of Managed Health Care (DMHC) is to ensure health plan members have access to equitable, high-quality, timely, and affordable health care within a stable health care delivery system
  • How to File a Complaint - California Department of Managed Health Care
    Independent Medical Review Complaint Process If your Health Plan denies, changes or delays your request for medical services, denies payment for emergency treatment or refuses to cover experimental or investigational treatment for a serious medical condition, you can apply for an Independent Medical Review (IMR) You can also file a Consumer Complaint when you have other issues with your
  • Health Care in California - California Department of Managed Health Care
    Health Care in California The healthcare landscape in California can be confusing Consumers have questions about the types of health plans available, how to find the best plan and how to get the best care Once insured, consumers might have questions about their health care rights and what to do if they have an issue with their plan
  • DMHC Laws Regulations - California Department of Managed Health Care
    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
  • Behavioral Health Care - California Department of Managed Health Care
    The Department of Managed Health Care (DMHC) refers to treatment and services provided to treat mental health and substance use conditions as behavioral health care
  • Pharmacy Benefit Manager Registration - California Department of . . .
    As defined in Health and Safety Code Section 1385 001, a “pharmacy benefit manager” is a person, business, or other entity that, pursuant to a contract with a health care service plan, manages the prescription drug coverage provided by the health care service plan This includes, but is not limited to, the processing and payment of claims for prescription drugs, the performance of drug
  • About the DMHC - California Department of Managed Health Care
    The mission of the Department of Managed Health Care (DMHC) is to ensure health plan members have access to equitable, high-quality, timely, and affordable health care within a stable health care delivery system
  • Contact Us - California Department of Managed Health Care
    Mailing Address Department of Managed Health Care 980 9th Street, Suite 500 Sacramento, CA 95814-2725 Visiting Address The Department’s downtown Sacramento office is currently not accessible to the public If you have a need for in-person services, please email PublicAccessRequest@dmhc ca gov to request an appointment
  • Frequently Asked Questions - California Department of Managed Health Care
    Frequently asked questions for enrollees and providers For Enrollees I recently enrolled in a health plan through Covered California; can I file a complaint with the Department of Managed Health Care? Yes Currently, the Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI) regulate Covered California health plans At this time, the DMHC regulates the vast
  • Transgender, Gender Diverse, or Intersex (TGI) Care
    Yes, health plans licensed by the California Department of Managed Health Care (DMHC) and insurers licensed by the California Department of Insurance (CDI) are required by California law to provide health plan enrollees who identify as transgender, gender diverse, or intersex (TGI) with medically necessary Gender Affirming Care





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