The DMHC licenses and regulates California health plans. We strive to streamline the process health plans must follow to comply with California law. This section has all the information plans need in easy and convenient formats.
The Department utilizes detailed audit tools when conducting medical surveys of both licensed full service and specialty plans in order to ensure compliance with the Knox-Keene Act (Act), Title 28 of the California Code of Regulations, and any recent case law. This generic protocol document, called a Technical Assistance Guide (TAG), is used by the surveyors in measuring a plan's performance and determining compliance against the relevant legal requirements. The standard TAG tools are updated on a semi-annual basis (typically in June and January of each year) based on legislative changes to the Act, as well as updated regulations. The TAGs may also be tailored to each Plan based on compliance history and overall survey strategy for a particular type of health plan.
The Department also develops specialized TAG tools based on statutes and regulations of the Act to conduct investigative or non-routine surveys that typically have a specific and limited scope. The TAGs currently available are listed below and may be accessed through this page. Additional TAGs may be added to this page in the future.
The Department welcomes any comments, inquiries or questions that you might have regarding the survey audit tools. Please submit your inquiry to:
