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Breeze california psychology1/29/2024 click here for the MEDIGAP coverage page on CDI's website Medicare Supplemental Insurance or MEDIGAP coverage is administered in California through the Department of Insurance (CDI). Medicare is regulated primarily by the Center for Medicare and Medicaid Services (CMS) click here for CMS' website Examples of ACA consumer protections include covering children under a parent’s policy to age 26, elimination of lifetime cost caps, and coverage of preventive care without copay or deductible. click here for CDI's websiteĬompliance with the consumer protections required under the Affordable Care Act (ACA) is enforced by Covered California, the Department of Managed Health Care and the Department of Insurance. Private health insurance plans not involving managed care, including many Preferred Provider Organizations or PPOs and some other insurance plans, are regulated by the California Department of Insurance (CDI). In addition, there is an independent long-term care Ombudsman program to help persons in nursing and other health facilities and in residential care facilities. Several agencies such as the Department of Health Care Services (DHCS) and the California Department of Public Health (DPH) have an “Ombudsman” office which is an office assigned to answer consumer questions and to resolve complaints. There are no DMHC licensed plans under Denti-Cal, county Mental Health Medi-Cal Managed Care, and, except for the San Mateo county health plan, County Operated Health Systems (COHS) covering Medi-Cal recipients in the following counties: Del Norte, Humboldt, Lake, Lassen, Marin, Mendocino, Merced, Modoc, Monterey, Napa, Orange, San Luis Obispo, Santa Barbra, Sa Many Medi-Cal managed care plans are licensed by DMHC and therefore the consumer protections available in private or commercial plans are also available to Medi-Cal beneficiaries. Medi-Cal, Denti-Cal, and Mental Health care, whether managed care or fee-for-service, are regulated by the California Department of Health Care Services (DHCS). Private or commercial managed care plans are regulated by the California Department of Managed Health Care (DMHC). Residential care facilities include board and care homes, community care facilities (CCFs), residential care facilities for the elderly (RCFE) and assisted living facilities. The Community Care Licensing (CCL) Division of the California Department of Social Services (CDSS) licenses and regulates most residential, day and child care services. General complaint information and links for specific complaints are found at click here for CDPH's website Hospitals, clinics, and nursing homes including subacute facilities are licensed and regulated by the California Department of Public Health (CDPH). All of the types of professionals licensed by the Department of Consumer Affairs are listed on its website. These include the Board of Medical Examiners, the Board of Dentistry, the Board of Psychology, the Board of Behavioral Services, the Board of registered Nurses and others. Most health-related professional services delivered by clinicians are regulated by the California Department of Consumer Affairs (DCA), and the licensing divisions or “Boards” pertaining to the type of service. People often use confusing acronyms or nicknames to identify these organizations so we have included them in bold also. Below is a brief summary of the agencies which regulate health care services. Health and residential care in California is regulated by many different agencies. We have also included a list of some of the advocacy organizations and sources of information about your rights that may also be helpful. We have listed the government agencies with specific responsibility for addressing complaints first. This publication may be helpful to you if you need information or have a complaint regarding health care providers, programs, facilities, or services you have received.
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