September 12, 2025
What You Need to Know: DMHC has ordered health plans to end their contracts with Meritage Health Plan and reassign nearly 11,000 Medicare Advantage enrollees by October 31, 2025, following Meritage’s ongoing financial solvency issues.
The California Department of Managed Health Care (DMHC) has issued an enforcement action requiring health plans that subcontract with Meritage Health Plan to terminate those agreements and reassign the covered lives no later than October 31, 2025.
The August enforcement action followed a January 27, 2025, cease-and-desist order that prohibited contracting health plans from sending new enrollees to Meritage Health Plan. The action was a result of Meritage’s failure to meet financial solvency requirements under California law since October 2024, posing a risk of insolvency.
According to the August 27, 2025, enforcement order, Meritage has a total of almost 11,000 Medicare Advantage enrollees assigned to it from the following health plans:
- Alignment
- Humana
- Scan
- Central
- Health Net
- UHC of California
Health plans that subcontract with Meritage are required to submit an action plan to DMHC by September 15, 2025, describing the steps they will take to comply and to maintain continuity of care as enrollees transition from Meritage.
This change reinforces the importance of verifying eligibility for patients before services are provided to ensure network participation status with the patient’s new plan or delegated group.
Physicians with outstanding claims are encouraged to contact Meritage Health Network to inquire about the status of those claims at (415) 884-1840 (Nor Cal) or (833) 446-1758 (Central Valley) or via email at claimsmgmt@meritagemed.com.