In California, the California Department of Insurance (CDI) is responsible for regulating health insurance. Their mission is to protect consumers, promote a dynamic and stable insurance market, and enforce laws related to health insurance and the health insurance code in a fair and unbiased manner. The Department of Managed Health Care (DMHC) was established in 2000 through consumer-sponsored legislation and is responsible for regulating health care and health insurance for 25 million Californians, including those with Obamacare California plans insured through Covered California. The CDI does not regulate products from the California Department of Insurance (CDI) or most Medicare coverage.
The CAHP follows the regulatory measures of the California Department of Managed Health Care (DMHC), the California Department of Health Services (DHCS), the Office of the Patient Advocate (OPA), Covered California and the Centers for Medicare and Medicaid Services (CMS). The state government is responsible for overseeing health care facilities through multiple agencies, departments, boards, offices and commissions. For the purpose of this tool, “center” means inpatient and outpatient healthcare facilities, health services such as palliative care and home health care, and sites related to health care, such as manufacturers of drugs and medical devices and pharmacy wholesalers. The DMHC regulates 121 California health insurance plans, including 72 full-service plans and 49 specialized plans. The state government provides a one-stop-shop for information on how health plans are working to provide Californians with affordable access to quality health care.
It is important to understand who regulates health care in California so that you can make informed decisions about your own health care.