Commercial Insurance / Managed Care

New Reporting Process for Managed Care Plan Issues

Working in partnership with CHA, the California Department of Managed Health Care (DMHC) and the Department of Health Care Services (DHCS) have developed a process for hospital case managers and others to report concerns about health plan communication and prior authorization practices.  

CHA to Host Member Forum on Draft Medi-Cal Managed Care RFP

On June 17 from 3 to 4 p.m. (PT), CHA will host a member forum to present an overview of the draft request for proposal for the Medi-Cal managed care plan (MCP) contract and the upcoming Medi-Cal MCP procurement that was released by the Department of Health Care Services on June 1.  Ryan Witz, CHA vice president of health care […]

DMHC Releases Guidance on General Licensure Regulation

The Department of Managed Health Care (DMHC) has released final guidance on its Knox-Keene licensure regulation, which applies to any contract entered into, amended, or renewed on or after July 1. The regulation, among other things, defines various types of risk and requires entities that assume any amount of global risk to either obtain a license under the Knox-Keene Health Care Service Plan Act of 1975 or receive an exemption from DMHC. 

May 20 Marks Comment Deadline for DMHC Draft Implementation Guidance on Licensure Regulation

The Department of Managed Health Care (DMHC) has released draft guidance and accompanying forms — a confidentiality request form and an expedited exemption request form — related to its Knox-Keene licensure regulation. The regulation, among other things, defines various types of risk and requires entities that assume any amount of global risk to either obtain a license under the Knox-Keene Health Care Service Plan Act of 1975 or receive an exemption from DMHC.