California Fines 18 Medicaid Managed Care Plans More Than $3 Million For Poor Performance

The California Department of Health Care Services (DHCS) published quality ratings and imposed a total of $3,355,000 in monetary sanctions on 18 Medi-Cal (California's Medicaid program) managed care plans (MCP) that did not meet required minimum performance levels in market year (MY) 2022. Under their contracts with DHCS, all plans (both MCPs and county behavioral health plans) are required to meet the DHCS-established MPLs for each Medi-Cal Managed Care Accountability Set (MCAS) performance measure.

The sanctions ranged from $25,000 to $890,000. The size of the monetary sanction is based on factors that . . .