This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.

Medi-Cal Managed Care Capitation Rates for Capitated Rates for Senior Care Action Network (SCAN) – by Calendar Year. Senior Care Action Network (SCAN) Health Plan is a Medicare Advantage Special Needs Plan that contracts with the Department of Health Care Services for dual eligible Medicare/Medi-Cal population subset residing in Los Angeles, San Bernardino, and Riverside counties.

Medi-Cal Managed Care Capitation Rates for Capitated Rates for Senior Care Action Network (SCAN) – by Calendar Year. Senior Care Action Network (SCAN) Health Plan is a Medicare Advantage Special Needs Plan that contracts with the Department of Health Care Services for dual eligible Medicare/Medi-Cal population subset residing in Los Angeles, San Bernardino, and Riverside counties.

This dataset includes the total number of individuals enrolled in Medi-Cal by eligibility group: Modified Adjusted Gross Income (MAGI), non-MAGI, and Children’s Health Insurance Program (CHIP). The groups are defined by the Centers for Medicare and Medicaid Services (CMS) Performance Indicators (CMSPI) reporting requirements. The Department of Health Care Services (DHCS) submits eligibility and enrollment data regarding Medicaid and CHIP monthly to CMS. The enrollment data represents enrollment totals as of 60 days after the eligibility month (indicated as “Reporting Period” in the dataset). CMS publishes the state total enrollments on the CMSPI website. The total enrollment comprises of individuals who are eligible for full scope Medi-Cal by MAGI – Child, MAGI – Adult, Non-MAGI Child, Non-MAGI Adult, and CHIP eligibility groups. DHCS does not report to CMS the total enrollment in limited scope Medi-Cal or state-only funded programs (indicated as the “Non-CMSPI” in the dataset).

This dataset displays reimbursement rates paid to Medi-Cal Managed Care health plans in the COHS model, by State Fiscal Year. The COHS serve beneficiaries in 22 counties. In the COHS model counties, the Department of Health Care Services (DHCS) contracts with a health plan created by the county Board of Supervisors. In a COHS county, all Medi-Cal members are enrolled in the same managed care health plan.

This dataset displays reimbursement rates paid to Medi-Cal Managed Care health plans in the COHS model, by State Fiscal Year. The COHS serve beneficiaries in 22 counties. In the COHS model counties, the Department of Health Care Services (DHCS) contracts with a health plan created by the county Board of Supervisors. In a COHS county, all Medi-Cal members are enrolled in the same managed care health plan.

The dataset provides basic information of the FFS providers enrolled in the Medi-Cal program as of April 1, 2024. The data was retrieved from the Provider Master File (PMF), which has been used in the claims payment process and maintained by the Provider Enrollment Division (PED). The Variables in the dataset include provider number, name, type, specialty, geographic information, etc. This dataset does not include the Managed Care providers.

This dataset displays reimbursement rates paid to Medi-Cal Managed Care health plans in Two-Plan model counties by State Fiscal Year. In Two-Plan model counties, the Department of Health Care Services (DHCS) contracts with a local initiative (county organized) and a commercial plan.