A consumer enrolls in a California Health Maintenance Organization (HMO). Which state agency has primary regulatory authority over that HMO?

a.California Department of Insurance (CDI)
b.California Department of Managed Health Care (DMHC)
c.California Department of Public Health (CDPH)
d.Centers for Medicare & Medicaid Services (CMS)

Explanation

Under the Knox-Keene Health Care Service Plan Act, California HMOs are regulated by the Department of Managed Health Care (DMHC), not the CDI. The CDI regulates indemnity health insurance and PPO products, but full-service HMOs fall under DMHC.

Law Reference: Cal. Health & Safety Code §1340 et seq. (Knox-Keene Act)

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