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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

CY 2021 Rate Certification Report
CY 2021 Rate Certification Report – UIS Amendment
CY 2022 Rate Certification Report
CY 2022 Rate Certification Report – Amended
CY 2022 Rate Certification Report – UIS Amendment
CY 2023 Rate Certification Report
CY 2023 Rate Certification Report – Amended
CY 2024 Rate Certification Report
CY 2024 Rate Certification Report – Amended
CY 2025 Rate Certification Report
CY 2026 Rate Certification Report

Specialty Program 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.

State Oversight of Medical Loss Ratio Work Plan

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.