This data is from the California Department of Managed Health Care (DMHC). It contains all information on health plan proposed premium rates filed with the DMHC since January 1, 2011. The DMHC is committed to providing the public with information in order to expand consumer understanding about premium rate increases. The DMHC does not have the authority to approve or deny rate increases; however, the DMHC's review of proposed premium rates improves accountability in health plan rate setting and often results in a reduction in the proposed rate.

This data is from the California Department of Managed Health Care (DMHC). It contains all Provider complaints received by the DMHC since January 1, 2019.

This data is from the California Department of Managed Health Care (DMHC). It contains all Provider complaints received by the DMHC since January 1, 2019.

This data is from the Office of Enforcement in the California Department of Managed Health Care (DMHC). It contains enforcement actions with the information of the organization type, organization name, action date, penalty amount, related party, and violation section (California Health and Safety Code and the California Code of Regulations, title 28) since July 1, 2000. The DMHC Office of Enforcement investigates alleged violations of the Knox-Keene Health Care Service Plan Act of 1975 (the Knox-Keene Act) under the DMHC's administrative powers as a California state licensing agency. The DMHC Office of Enforcement exercises its jurisdiction to prosecute violators in an administrative action before the Director of the DMHC, the Office of Administrative Hearings, or in the California Superior Courts. When the DMHC finds the Knox-Keene Act is violated, the Director is authorized to take a variety of actions, including, assessing administrative penalties and issuing a cease and desist order requiring the subject of the order to stop the offending action. All subjects are afforded appropriate Due Process protections. For additional information, please visit http://www.dmhc.ca.gov/LawsRegulations/EnforcementActions.aspx.

This data is from the Office of Enforcement in the California Department of Managed Health Care (DMHC). It contains enforcement actions with the information of the organization type, organization name, action date, penalty amount, related party, and violation section (California Health and Safety Code and the California Code of Regulations, title 28) since July 1, 2000. The DMHC Office of Enforcement investigates alleged violations of the Knox-Keene Health Care Service Plan Act of 1975 (the Knox-Keene Act) under the DMHC's administrative powers as a California state licensing agency. The DMHC Office of Enforcement exercises its jurisdiction to prosecute violators in an administrative action before the Director of the DMHC, the Office of Administrative Hearings, or in the California Superior Courts. When the DMHC finds the Knox-Keene Act is violated, the Director is authorized to take a variety of actions, including, assessing administrative penalties and issuing a cease and desist order requiring the subject of the order to stop the offending action. All subjects are afforded appropriate Due Process protections. For additional information, please visit http://www.dmhc.ca.gov/LawsRegulations/EnforcementActions.aspx.

This data is from the California Department of Managed Health Care (DMHC). It contains all decisions from Independent Medical Reviews (IMR) administered by the DMHC since January 1, 2001. An IMR is an independent review of a denied, delayed, or modified health care service that the health plan has determined to be not medically necessary, experimental/investigational or non-emergent/urgent. If the IMR is decided in an enrollees favor, the health plan must authorize the service or treatment requested.

This data is from the California Department of Managed Health Care (DMHC). It contains all decisions from Independent Medical Reviews (IMR) administered by the DMHC since January 1, 2001. An IMR is an independent review of a denied, delayed, or modified health care service that the health plan has determined to be not medically necessary, experimental/investigational or non-emergent/urgent. If the IMR is decided in an enrollees favor, the health plan must authorize the service or treatment requested.

Medi-Cal Managed Care Capitation Rates – Geographic Managed Care (GMC) by State Fiscal Year. Medi- Cal managed care health plans in the Sacramento and San Diego 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.

The CMS Program Statistics - Medicare Part D tables provide use and Part D drug costs by type of Part D plan (stand-alone prescription drug plan and Medicare Advantage prescription drug plan). For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. Below is the list of tables: MDCR UTLZN D 1. Medicare Part D Utilization: Average Annual Prescription Drug Fills by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Generic Dispensing Rate, Yearly Trend MDCR UTLZN D 2. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend MDCR UTLZN D 3. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend MDCR UTLZN D 4. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan and Demographic Characteristics MDCR UTLZN D 5. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan and Demographic Characteristics MDCR UTLZN D 6. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan, by Area of Residence MDCR UTLZN D 7. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan, by Area of Residence MDCR UTLZN D 8. Medicare Part D Utilization: Number of Part D Utilizers and Average Annual Prescription Drug Fills by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend MDCR UTLZN D 9. Medicare Part D Utilization: Number of Part D Utilizers and Drug Costs by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend MDCR UTLZN D 10. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Events (Fills) and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Demographic Characteristics MDCR UTLZN D 11. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Area of Residence