Issued in 2025

Health Net Community Solutions, Inc.

[Review Period 04/01/22 – 05/31/24]

Report & Corrective Action Plan

Issued in 2024

AIDS Healthcare Foundation

[Review Period 10/01/22 – 09/30/23]

Report & Corrective Action Plan

Alameda Alliance for Health

[Review Period 06/01/23 – 05/31/24]

Report & Corrective Action Plan

Anthem Blue Cross Partnership Plan

[Review Period 10/01/22 – 10/31/23]

Report & Corrective Action Plan

Blue Shield of CA Promise Health Plan

[Review Period 04/01/23 – 03/31/24]

Report & Corrective Action Plan

CalOptima

[Review Period 02/01/23 – 02/29/24]

Report & Corrective Action Plan

CalViva Health

[Report Period 04/01/23 – 03/31/24]

Report & Corrective Action Plan

Central California Alliance for Health

[Review Period 11/01/22 – 10/31/23]

Report & Corrective Action Plan

Community Health Group Partnership Plan

[Review Period 06/01/23 – 05/31/24]

Report & Corrective Action Plan

Contra Costa Health Plan

[Review Period 07/01/22 – 06/30/23]

Report & Corrective Action Plan

Health Plan of San Joaquin

[Review Period 10/01/22 – 07/31/23]

Report & Corrective Action Plan

Health Plan of San Mateo

[Review Period 07/01/22 – 06/30/23]

Report & Corrective Action Plan

Inland Empire Health Plan

[Review Period 08/01/22 – 07/31/23]

Report & Corrective Action Plan

Kaiser

[Review Period 11/01/22 – 10/31/23]

Report & Corrective Action Plan

Kern Health Systems

[Review Period 11/01/22 – 10/31/23]

Report & Corrective Action Plan

Molina Healthcare of California Partner Plan, Inc.

[Review Period 03/01/23 – 02/29/24]

Report & Corrective Action Plan

Partnership Health Plan of California

[Review Period 07/01/22 – 06/30/23]

Report & Corrective Action Plan

San Francisco Health Plan

[Review Period 03/01/23 – 03/31/24]

Report & Corrective Action Plan

Santa Clara Family Health Plan

[Review Period 03/01/23 – 01/31/24]

Report & Corrective Action Plan

Senior Care Action Network Health Plan

[Review Period 03/01/23 – 02/29/24]

Report & Corrective Action Plan

Issued in 2023

Alameda Alliance for Health

[Review Period 04/01/22 – 03/31/23]

Report & Corrective Action Plan

Anthem Blue Cross Partnership Plan

[Review Period 10/01/21 – 09/30/22]

Report & Corrective Action Plan

Blue Shield of CA Promise Health Plan

[Review Period 04/01/22 – 03/31/23]

Report & Corrective Action Plan

California Health and Wellness

[Review Period 07/01/22 – 06/30/23]

Report & Corrective Action Plan

[Review Period 05/01/21 – 06/30/22]

Report & Corrective Action Plan

CalOptima

[Review Period 02/01/22 – 01/31/23]

Report & Corrective Action Plan

CalViva Health

[Review Period 04/01/22 – 03/31/23]

Report & Corrective Action Plan

CenCal Health

[Review Period 10/01/22 – 09/30/23]

Report & (Corrective Action Plan N/A)

[Review Period 10/01/21 – 09/30/22]

Report & Corrective Action Plan

Central California Alliance for Health

[Review Period 11/01/21 – 10/31/22]

Report & (Corrective Action Plan N/A)

Community Health Group Partnership Plan

[Review Period 06/01/22 – 05/31/23]

Report & Corrective Action Plan

[Review Period 06/01/21 – 05/31/22]

Report (Corrective Action Plan in progress)

Contra Costa Health Plan

[Review Period 07/01/21 – 05/31/22]

Report (Corrective Action Plan in progress)

Gold Coast Health Plan

[Review Period 07/01/22 – 06/30/23]

Report & Corrective Action Plan

[Review Period 06/01/21 – 05/31/22]

Report & Corrective Action Plan

Health Plan of San Joaquin

[Review Period 07/01/21 – 09/30/22]

Report & Corrective Action Plan

Inland Empire Health Plan

[Review Period 08/01/21 – 07/31/22]

Report & Corrective Action Plan

Kaiser

[Review Period 11/01/21 – 10/31/22]

Report & Corrective Action Plan

Kern Health Systems

[Review Period 11/01/21 – 10/31/22]

Report & Corrective Action Plan

L.A. Care Health Plan

[Review Period 07/01/21 – 01/31/23]

Report (Corrective Action Plan in progress)

Molina Healthcare of California Partner Plan, Inc.

[Review Period 05/01/22 – 04/30/23]

Report & (Corrective Action Plan N/A)

[Review Period 08/01/19 – 04/30/22]

Report & Corrective Action Plan

Partnership Health Plan of California

[Review Period 07/01/21 – 06/30/22]

Report & Corrective Action Plan

San Francisco Health Plan

[Review Period 03/01/22 – 02/28/23]

Report & Corrective Action Plan

Santa Clara Family Health Plan

[Review Period 03/01/22 – 02/28/23]

Report & Corrective Action Plan

[Review Period 03/01/21 – 02/28/22]

Report & Corrective Action Plan

Senior Care Action Network Health Plan

[Review Period 03/01/22 – 02/28/23]

Report & Corrective Action Plan

Issued in 2022

Aetna Better Health of California

[Review Period 04/01/21 – 03/31/22]

Report & Corrective Action Plan

AIDS Healthcare Foundation

[Review Period 01/01/21 – 12/31/21]

Report & Corrective Action Plan

Alameda Alliance for Health

[Review Period 04/01/21 – 03/31/22]

Report & Corrective Action Plan 

Anthem Blue Cross Partnership Plan

[Review Period 10/01/19 – 07/31/21]

Report (Corrective Action Plan in progress)

Blue Shield of CA Promise Health Plan

[Review Period 01/01/21 – 12/31/21]

Report & Corrective Action Plan

Report (Cal MediConnect) & Corrective Action Plan (Cal MediConnect)

CalOptima

[Review Period 02/01/20 – 12/31/21]

Report & Corrective Action Plan

CalViva Health

[Review Period 04/01/20 – 03/31/22]

Report & Corrective Action Plan

CenCal Health

[Review Period 11/01/19 – 09/30/21]

Report & Corrective Action Plan

Central California Alliance for Health

[Review Period 11/01/19 – 10/31/21]

Report & Corrective Action Plan

Health Net Community Solutions, Inc.

[Review Period 04/01/21 – 03/31/22]

Report (Corrective Action Plan in progress)

Health Plan of San Joaquin

[Review Period 07/01/19 – 06/30/21]

Report & Corrective Action Plan

Health Plan of San Mateo

[Review Period 11/01/19 – 07/31/21]

Report (Medical Audit and Cal MediConnect) 

Corrective Action Plan (Medical Audit)

Corrective Action Plan (Cal MediConnect)

[Review Period 08/01/21 – 06/30/22]

Report & Corrective Action Plan  

Inland Empire Health Plan

[Review Period 10/01/19 – 07/31/21]

Report & Corrective Action Plan

Report (Cal MediConnect) & Corrective Action Plan (Cal MediConnect)

Kaiser

[Review Period 09/01/19 – 10/31/21]

Report & Corrective Action Plan

Kern Health Systems

[Review Period 08/01/19 – 07/31/21]

Report & Corrective Action Plan

L.A. Care Health Plan

[Review Period 07/01/19 – 06/30/21]

Report (Corrective Action Plan in progress)

[Review Period 07/01/20 – 06/30/21]

Report (Cal MediConnect) (Corrective Action Plan in progress)

Partnership Health Plan of California

[Review Period 01/01/20 – 06/30/21]

Report & (Corrective Action Plan N/A)

San Francisco Health Plan

[Review Period 03/01/21 – 02/28/22]

Report & Corrective Action Plan

Senior Care Action Network Health Plan

[Review Period 03/01/21 – 02/28/22]

Report & Corrective Action Plan

Issued in 2021

Aetna Better Health of California

[Review Period 04/01/19 – 03/31/21]

Report (Corrective Action Plan in progress)

AIDS Healthcare Foundation

[Review Period 01/01/20 – 12/31/20]

Report & Corrective Action Plan

Alameda Alliance for Health

[Review Period 06/01/19 – 03/31/21]

Report & Corrective Action Plan

[Review Period 10/01/18 – 09/30/20]
Corrective Action Plan (Focused)

Blue Shield of CA Promise Health Plan

[Review Period 01/01/20 – 12/31/20]

Report & Corrective Action Plan

California Health and Wellness

[Review Period 12/01/19 – 04/30/21]

Report & Corrective Action Plan

Community Health Group Partnership Plan

[Review Period 06/01/19 – 05/31/21] (Medical Audit)

[Review Period 06/01/20 – 05/31/21] (Cal MediConnect)

Report (Medical Audit and Cal MediConnect) & Corrective Action Plan (Medical Audit)

Corrective Action Plan (Cal MediConnect)

Contra Costa Health Plan

[Review Period 07/01/20 – 06/30/21]

Report & Corrective Action Plan

Gold Coast Health Plan

[Review Period 04/01/19 – 05/31/21]

Report & Corrective Action Plan

Health Net Community Solutions, Inc.

[Review Period 05/01/19 – 03/31/21]
Report (Corrective Action Plan in progress)

[Review Period 04/01/20 – 03/31/21]

Report (Cal MediConnect) & Corrective Action Plan (Cal MediConnect)

[Review Period 01/01/19 – 12/31/20]
Report (Focused) (Corrective Action Plan in progress)

L.A. Care Health Plan

[Review Period 01/01/19 – 12/31/20]

Report (Focused) (Corrective Action Plan in progress)

Rady Children’s Hospital-San Diego

[Review Period 09/01/19 – 08/31/20]
Report & Corrective Action Plan

San Francisco Health Plan

[Review Period 03/01/20 – 02/28/21]

Report (Corrective Action Plan in progress)

Santa Clara Family Health Plan

Review Period 03/01/20 – 02/28/21]
Report & Corrective Action Plan

Senior Care Action Network Health Plan

[Review Period 03/01/20 – 02/28/21]

Report & Corrective Action Plan

United Healthcare Community Plan of California, Inc.

[Review Period 06/01/19 – 05/31/21]

Report & Corrective Action Plan

Issued in 2020

AIDS Healthcare Foundation

[Review Period 01/01/19 – 12/31/19]
Report & Corrective Action Plan

Anthem Blue Cross Partnership Plan

[Review Period 10/01/18 – 09/30/19]
Report & Corrective Action Plan

Report (Cal MediConnect) & Corrective Action Plan (Cal MediConnect)

California Health and Wellness

[Review Period 12/01/18 – 11/30/19]
Report & Corrective Action Plan

CalOptima

[Review Period 02/01/19 – 01/31/20]
Report & Corrective Action Plan

CalViva Health

[Review Period 02/01/19 – 01/31/20]
Report & Corrective Action Plan

CenCal Health

[Review Period 11/01/18 – 10/31/19]
Report & Corrective Action Plan

Central California Alliance for Health

[Review Period 11/01/18 – 10/31/19]
Report & Corrective Action Plan

Contra Costa Health Plan

[Review Period 05/01/19 – 04/30/20]
Report & Corrective Action Plan

Health Plan of San Mateo

[Review Period 11/01/18 – 10/31/19]
Report & Corrective Action Plan

Inland Empire Health Plan

[Review Period 10/01/18 – 09/30/19]
Report & Corrective Action Plan

Kaiser

[Review Period 09/01/18 – 08/31/19]
Report & Corrective Action Plan

Molina Healthcare of California Partner Plan, Inc.

[Review Period 08/01/18 – 07/31/19]
Report & Corrective Action Plan

San Francisco Health Plan

[Review Period 03/01/19 – 02/29/20]

Report & Corrective Action Plan

Santa Clara Family Health Plan

[Review Period 03/01/19 – 02/29/20]
Report & Corrective Action Plan

Senior Care Action Network Health Plan

[Review Period 03/01/19 – 02/29/20]
Report & Corrective Action Plan

Issued in 2019

Aetna Better Health of California

[Review Period 04/01/18 – 03/31/19]
Report & Corrective Action Plan

Community Health Group Partnership Plan

[Review Period 06/01/18 – 05/31/19]
Report & Corrective Action Plan

Contra Costa Health Plan

[Review Period 06/01/18 – 03/31/19]
Report & Corrective Action Plan

Health Net Community Solutions, Inc.

[Review Period 05/01/18 – 04/30/19]

Report & Corrective Action Plan

Health Plan of San Joaquin

[Review Period 07/01/18 – 06/30/19]

Report & (Corrective Action Plan N/A)

Health Plan of San Mateo

[Review Period 11/01/17 – 09/30/18]
Report (Cal MediConnect) & Corrective Action Plan (Cal MediConnect)

Kern Health Systems

[Review Period 08/01/18 – 07/31/19]
Report & Corrective Action Plan

L.A. Care Health Plan

[Review Period 07/01/18 – 06/30/19]
Report & Corrective Action Plan

Partnership Health Plan of California

[Review Period 01/01/18 – 12/31/18]
Report & Corrective Action Plan

San Francisco Health Plan

[Review Period 03/01/18 – 02/28/19]
Corrective Action Plan

Santa Clara Family Health Plan

[Review Period 04/01/18 – 02/28/19]

Report & Corrective Action Plan

Report (Cal MediConnect) & Corrective Action Plan (Cal MediConnect)

Senior Care Action Network Health Plan

[Review Period 03/01/18 – 02/28/19]
Report & Corrective Action Plan

United Healthcare Community Plan of California, Inc.

[Review Period 04/01/18 – 04/30/19]
Report & Corrective Action Plan

Issued in 2018

Alameda Alliance for Health

[Review Period 06/01/17 – 05/31/18]
Report & (Corrective Action Plan N/A)

CalOptima

[Review Period 02/01/17 -01/31/18]
Report & Corrective Action Plan

Central California Alliance for Health

[Review Period 11/01/16 – 10/31/17]
Report & Corrective Action Plan 

Community Health Group Partnership Plan

[Review Period 06/01/17 – 05/31/18]
Report & (Corrective Action Plan N/A)

Contra Costa Health Plan

[Review Period 06/01/17 – 05/31/18]
Corrective Action Plan

Gold Coast Health Plan

[Review Period 04/01/17 – 03/31/18]
Report & Corrective Action Plan   

Health Net Community Solutions, Inc.

[Review Period 05/01/17 – 04/30/18]
Corrective Action Plan

Health Plan of San Joaquin

[Review Period 07/01/17 – 06/30/18]

Report & Corrective Action Plan

Health Plan of San Mateo

[Review Period 11/01/16 – 09/30/17]

Report (Corrective Action Plan in progress)

Inland Empire Health Plan

[Review Period 10/01/16 – 09/30/17]
Report & Corrective Action Plan    

Kaiser

[Review Period 09/01/16 – 08/31/17]
Report (Corrective Action Plan N/A)     

Partnership Health Plan of California

[Review Period 01/01/17 – 12/31/17]
Report & Corrective Action Plan

San Francisco Health Plan

[Review Period 03/01/17 – 02/28/18]
Report & Corrective Action Plan

Santa Clara Family Health Plan

[Review Period 04/01/17 – 03/31/18]
Report & Corrective Action Plan