Transparency

CalOptima Health Bylaws 
This document is the current Bylaws of Orange County Health Authority (CalOptima Health), as amended and revised April 6, 2023.

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 is required to submit 60-day, six-month and one-year status updates to CSA regarding the implementation of the report’s seven recommendations. As of the submission of the six-month status update on November 2, 2023, no further recommendations are pending implementation. To promote transparency and accountability, CalOptima Health has also decided to publicly post the three status updates below:

60-Day Status Update (July 1, 2023) 

Six-Month Status Update (November 2, 2023) 

One-Year Status Update (anticipated after May 2, 2024)

Form 802 is used by all state and local government agencies. It identifies persons who receive admission tickets and passes, and describes the public purpose for the distribution.

Solicitation and Receipt of Gifts to CalOptima  
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.

Public Records Request Form 
This form can be used to make written requests for public records containing information relating to the conduct of the public’s business that is prepared, owned, used or retained by CalOptima. For more information on public records request, see California Government Code section 6250 et seq. and CalOptima Policy AA.1215.

You may email us at publicrecordsrequest@caloptima.org to submit your Public Records Request.

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 healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.

Machine Readable Files (MRFs) - Cigna  

Machine Readable Files (MRFs) - Kaiser