Department of Managed Healthcare

The California Department of Managed Healthcare (“DMHC”) reviews all aspects of a health plan’s operations, including benefits and coverage (Evidences of Coverage), template contracts with doctors and hospitals, provider networks, mental health parity and complaint and grievance systems. After licensure, the DMHC monitors health plans and any changes made to plan operations, including changes in service areas, contracts, benefits or systems. The DMHC also periodically identifies specific licensing issues for focused examination or investigation.

Additionally, the DMHC is responsible for protecting consumers’ health care rights and ensures a stable health care delivery system. The DMHC Help Center educates consumers about their health care rights, resolves consumer complaints against health plans, helps consumers understand their coverage and assists consumers in getting timely access to appropriate health care services. The DMHC Help Center provides direct assistance in all languages to health care consumers through the Department’s website, www.HealthHelp.ca.gov, and a toll-free phone number, 1-888-466-2219.