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Californians are fortunate to have the strongest patients' rights laws in the nation. The DMHC is here to make sure these laws are followed and that all health plan members get the right care at the right time. Find out how in this section.
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Request For General Information
All records held by the Department are public records unless they are exempt from
disclosure. Much information concerning health plans is already posted on this
website. Before requesting information from the Department, please review posted
Information Available on This Website.
The Department has additional information on health plans that is available to
the public upon request. Examples of records that the public may review include:
- License applicant information
- License application exhibits
- Independent medical review determinations
- Rulemaking files for regulations promulgated by the Department
Legal requirements governing inspection of public records maintained by the Department
are provided in the California Code
of Regulations, Title 28, Division 1, Chapter 1, Article 2, § 1006, and in California's
Public Records Act (PRA), Government Code §§ 6250 et seq.
DMHC's Guidelines for Accessibility of Records.
The Department retains health plan records and reports for varying lengths of time. Rules
regarding record retention are provided in
California Code of Regulations, Title 28, Division 1, Chapter 1, Article 2, § 1009.
How to Request General Information
Requests for general information made under the PRA must be made in writing. Requestors
should specify as clearly as possible the records that they are seeking. To assist
the public in making requests, the Department has developed the following form, which may be submitted online:
It may take up to 10 days for the Department to review the PRA request
and inform the requestor of the determination of disclosable records.
Occasionally, the Department may need up to 14 additional days pursuant to Government Code Section 6253(c).
Requests may also be submitted by mail to:
Department of Managed Health Care
Office of Legal Services
980 9th Street, Suite 500
Sacramento, CA 95814
or submit via facsimile to (916) 322-3968.
How to View Public Records
Requestors have the option of viewing public records in person, having records
copied by the Department at a cost of $.30 per page, or hiring a copy service to
come to the Department and make copies. All arrangements to view or copy public
records must be scheduled in advance for the convenience of all parties.
Information Exempt from Disclosure
Some records and documents are exempt from public disclosure. In general, these
records are deemed confidential because they reveal personnel, medical or other
private information about an individual, or financial, trade secret, or competitive
information about a company or plan. Examples of records that are NOT available
for public viewing include:
- Records pertaining to pending litigation to which the Department is a party.
(Gov. Code § 6254(b))
- Preliminary drafts, notes or agency memoranda not retained in the ordinary
course of business, provided that the public interest in withholding the records
clearly outweighs the public interest in disclosure. (Gov. Code § 6254(a))
- Personnel, medical or similar files, the disclosure of which would constitute
an unwarranted invasion of personal privacy. (Gov. Code § 6254(c))
- Corporate proprietary information, such as trade secrets or financial
records (Gov. Code § 6254(k), Evidence Code § 1060)
- Peer review records (Gov. Code § 6254(k), Business and Professions Code §
805(g))
- Plan payments to providers (Gov. Code § 6254(k), Health & Saf. Code § 1351(d))
- Provider solvency information (Gov. Code § 6254(k), Health & Saf. Code § 1375.4 (b)(7))
The Department has the authority to withhold requested information if it determines
that the public interest in withholding a record clearly outweighs the public interest
in disclosing the record. (Gov. Code § 6255(a))
If you are requesting your own individual records or if you are representing someone
else, please click the back button or click on Request for Personal Information.
