California DMHC Finds 70 Knox-Keene Violations in Commercial Plan Behavioral Health Audits
The California Department of Managed Health Care identified 70 Knox-Keene Act violations across three investigation rounds involving commercial health plans' delivery of behavioral health services for mental health and substance use disorder treatment. The violations indicate systemic failures in timely access to care. While these investigations targeted commercial plans regulated under Knox-Keene, the findings may signal enforcement priorities that could extend to Medi-Cal managed care plans, which are also subject to DMHC oversight and similar network adequacy standards for behavioral health.
DMHC's aggressive enforcement posture on behavioral health access in commercial plans suggests heightened scrutiny for Medi-Cal MCOs, which face similar network adequacy requirements and may be subject to comparable audit protocols.
Behavioral Health · Managed Care
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