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Medi-Cal Managed Care Financial Reports

The Capitated Rates Development Division issues various reports and information related to Medi-Cal managed care health plans, including capitation rate ranges, manuals, actuarial certifications, capitation rates studies, rate development methodologies and other related information.

Medi-Cal Managed Care Rates

** Links lead to the California Health and Human Services (CHHS) Open Data Portal Website.

Rate Certifications

Specialty Program Rates

Dental Managed Care (DMC) Rates

Coordinated Care Initiative (CCI) and Cal MediConnect (CMC) Rates

AIDS Healthcare Foundation Rates

Rady’s Hospital Rates

CMS Annual MLR Report

These pages contain results related to 42 CFR 438.74(a) for the State of California’s Medi-Cal Managed Care Plans and Medi-Cal Dental Managed Care Plans.

State Oversight of Medical Loss Ratio Work Plan

This represents the Work Plan for the 1915(b) CalAIM Waiver, STC A11 that was submitted to CMS on November 30, 2022. 

Note: This Work Plan is subject to change and will be edited if CMS requests DHCS to make modifications.

California Risk Mitigation Evaluation Design

CMS approved the CalAIM Section 1115 demonstration and CalAIM Section 1915(b) waiver on December 29, 2021, both effective through December 31, 2026. 

CalAIM Section 1115 Demonstration
CMS Approval Letter for CA Risk Mitigation Evaluation Design

CMS Periodic Audit Reports

These links contain results related to 42 CFR 438.602(e) for the State of California’s Medi-Cal Managed Care and Medi-Cal Dental Managed Care Plans.

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