September 2, 2025, Report to the Legal Ad Hoc Committee of the Board of Directors of CalOptima Health Regarding Findings Related to CalOptima's Efforts to Acquire 14851 Yorba Street & 165 Myrtle Avenue
This document contains the current Bylaws of Orange County Health Authority (CalOptima Health), as amended and revised on May 2, 2024.
On May 2, 2023, the California State Auditor (CSA) released a report following a comprehensive nine-month audit of CalOptima Health that covered an eight-year period from January 2014 through June 2022. In accordance with the terms of the audit, CalOptima Health was required to submit 60-day, six-month and one-year status updates to CSA regarding the implementation of the report’s seven recommendations. Following its assessment of the one-year status update, CSA confirmed that CalOptima Health had fully implemented all recommendations without any further actions or responses required. To promote transparency and accountability, CalOptima Health is publicly posting audit materials.
California State Auditor Report (May 2, 2023)
60-Day Status Update (July 1, 2023)
This policy defines the criteria and procedure for gifts received from outside sources, in accordance with the Political Reform Act and the Federal Anti-Kickback Statute.
This form can be used to make written requests for public records containing information related to the conduct of the public’s business that is prepared, owned, used or retained by CalOptima Health. For more information on public records requests, see California Government Code Section 6250 et seq. and CalOptima Health Policy AA.1215.
These links lead to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and include negotiated service rates and out-of-network allowed amounts between health plans and health care providers. The machine-readable files are formatted to allow researchers, regulators and application developers to more easily access and analyze data.
January 31, 2024, from 1–2 p.m.
June 3, 2024, from 2–4 p.m.
August 29, 2024, from 9–11 a.m.
January 23, 2025, from 2–4 p.m.
March 27, 2025, from 1–3 p.m.
May 22, 2025, from 2–4 p.m.
September 25, 2025, from 2–4 p.m.
November 20, 2025, from 1–3 p.m.
This form can be used for claims for money or damages against CalOptima Health after pursuing all applicable administrative remedies and prior to filing a lawsuit. For more information on claim presentation, see California Government Code Section 900 et seq. and CalOptima Health Policy AA.1217.
The Voluntary Rate Range Intergovernmental Transfer (VRRP/IGT) Program is a Medi-Cal program funded by state funds and matching federal funds.
January 22, 2026, from 9-10 a.m.
March 18, 2026, from 9-10 a.m.
May 20, 2026, from 9-10 a.m.
July 15, 2026, from 9-10 a.m.
September 16, 2026, from 9-10 a.m.
November 18, 2026, from 9-10 a.m.
February 13, 2025, from 2–3 p.m.
March 13, 2025, from 2–3 p.m.
April 10, 2025, from 2–3 p.m.
March 13, 2025, from 2–3 p.m.
June 12, 2025, from 2–3 p.m.
July 10, 2025, from 2–3 p.m.
August 14, 2025, from 2–3 p.m.
September 11, 2025, from 2–3 p.m.
October 9, 2025, from 2–3 p.m.
November 5, 2025, from 2–3 p.m.
December 3, 2025, from 2–3 p.m.
January 12, 2026, from 11:00–12:00 p.m.
April 21, 2026, from 11:00–12:00 p.m.
July 21, 2026, from 11:00–12:00 p.m.
October 20, 2026, from 11:00–12:00 p.m.
Each year, the California Department of Health Care Services (DHCS) conducts medical surveys of CalOptima Health’s Medi-Cal program. These audits are detailed reviews of how CalOptima Health complies with DHCS contract requirements, regulations, and policies and procedures. They help DHCS monitor the program and find areas of non-compliance, so corrective actions can be taken.
Below are recent DHCS audit reports along with the related corrective action plans (CAP).
2023 Focused Audit ReportJanuary 14, 2026, from 9:00–10:00 a.m.
April 8, 2026, from 9:00–10:00 a.m.
July 8, 2026, from 9:00–10:00 a.m.
October 14, 2026, from 9–10:00 a.m.
CalOptima Health complies with regulations requiring the annual reporting of prior authorization metrics. These metrics list all medical items and services, excluding drugs, that require prior authorization, as well as the number of prior authorizations received, approved, and denied. To view the prior authorization metrics for the latest reporting year, please select the link for the appropriate line of business
CalOptima Health OneCare (HMO-D-SNP) - 2025 Report
CalOptima Health Medi-Cal - 2025 Report
January 15, 2026, from 9-10 a.m.
February 19,2026, from 9-10 a.m.
March 19, 2026, from 9-10 a.m.
April 16, 2026, from 9-10 a.m.
May 21, 2026, from 9-10 a.m.
June 18, 2026, from 9-10 a.m.
July 16, 2026, from 9-10 a.m.
August 20, 2026, from 9-10 a.m.
September 17, 2026, from 9-10 a.m.
October 15, 2026, from 9-10 a.m.
November 19, 2026, from 9-10 a.m.
December 17, 2026, from 9-10 a.m.
Hsien Chiang, Medical Director
Nicole Garcia, Director
Email: JILiaison@CalOptima.org
Phone: 714.723.5184