DMHC Fines Contra Costa Health Plan

The Department of Managed Health Care has levied a six-figure fine against the Contra Costa County Health Plan for a variety of ongoing fiscal irregularities.

The DMHC noted that the plan, which is the Medi-Cal managed care plan for Contra Costa County, had failed to meet tangible net equity requirements multiple times dating back more than a decade, and for failing to file financial reports in a timely manner after the agency asked it to do so.

According to the DMHC, Contra Costa County Health Plan failed to meet tangible net equity requirements – the amount of assets on hand relative to the risk it had assumed – nine times in 2002, 2007 and 2010. In one instance in 2007, its tangible net equity was nearly $1.1 million below the minimum threshold. 

As a result, the agency required Contra Costa Health Plan to file monthly financial reports after the 2007 incident. According to the DMHC, it filed those reports late on 28 separate occasions, often by three months or more. It also filed quarterly and even annual financial reports past deadlines on multiple occasions.

Altogether, the DMHC levied a $210,000 fine, with all but $60,000 suspended. If Contra Costa Health Plan files timely financial reports for the next two years and maintains at least 130% of the minimum tangible equity plus $2 million for the next year, the remaining $150,000 of the fine will be waived.