CalOptima Health Bylaws
This document contains the current Bylaws of Orange County Health Authority (CalOptima Health), as amended and revised on April 6, 2023.
State Audit
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)
Solicitation and Receipt of Gifts Policy
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
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.
Transparency in Coverage Rule
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.
Women, Infants & Children MOU Meetings
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.
Government Claim Form
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.