California Department of Managed Health Care
Can’t resolve a problem with your HMO? Contact the California Department of Managed Health Care for more information. To Submit a Provider Complaint to the Department of Managed Health Care, click here.
The Department of Managed Health Care created this web page as part of a pilot project to accept and review provider complaints. The new electronic submission will allow the Department to look at complaint submissions to ensure that health plans and their capitated providers have implemented claims processing standards, contract disclosures and the dispute resolution mandates of the Knox Keene Health Care Service Plans Act (AB1455).
The Department’s area of authority is limited to Health Maintenance Organizations (HMOs) and two PPO’s – Blue Cross and Blue Shield of California. Before reporting a problem with a health plan, you should verify that the plan is regulated by the Department. To view a list of the plans regulated by the Department of Managed Health Care, click here for HMO Reports.