Curated cohort / fixed public roster
California payer cohort
The Patient Access and Provider Directory APIs of California's Medi-Cal managed care plans and Covered California qualified health plan issuers, graded on the same public surfaces as every other endpoint here.
27organizations reviewed
8published a base URL we could verify
11endpoints listed
11answered on this run
8 of 27 member organizations publish a FHIR base URL this project could verify from public documentation, which is a curation record with a date on it, not a live figure; 11 verified endpoints are listed below. Of those, 11 answered when this page was generated, which is the measured number: it comes from this run's probes, and it moves when the endpoints do. The rest of the roster is recorded with the reason it could not be listed, because for a cohort whose membership is public and finite, the gap is itself a finding.
Every endpoint in this cohort is required to exist by the federal CMS Interoperability and Patient Access rule (CMS-9115-F), which obliges Medicaid managed care plans and qualified health plan issuers on the federal exchanges to expose a Patient Access API and a Provider Directory API over FHIR R4. That is the whole reason a cohort like this can be assembled at all: the membership list is public, the obligation is federal, and the surfaces are meant to be discoverable.
The rule requires the API. It does not require a plan to print its base URL where an unregistered visitor can read it, and nothing on this page treats a plan that does not as being out of compliance with anything. What a missing base URL costs is narrower and worth naming exactly: conformance stops being checkable by anyone who has not already entered a business relationship with the plan.
This cohort is not about California's Data Exchange Framework. The DxF runs through the Data Sharing Agreement and qualified health information organizations, and it does not require any of the surfaces graded here. Reading a grade on this page as a DxF result would be wrong in both directions.
CMS-0057-F adds Provider Access, Payer-to-Payer, and Prior Authorization APIs with compliance dates in January 2027. None of that is required yet and none of it is graded here. It is noted because these same endpoints are where it will land, which makes today's grades a baseline worth having before the deadline rather than after it.
Membership is the DHCS Medi-Cal managed care plan roster plus the Covered California issuer list, deduplicated: seven organizations run in both programs and appear once, tagged with both. SCAN Connections appears in the DHCS table but is scoped out here, because DHCS's own footnote describes it as a Medicare Advantage Special Needs Plan rather than an MCP contract.
Vendor-hosted platforms are the hard case and are handled explicitly. Several of these endpoints answer with a CapabilityStatement that names a vendor, or names nobody at all, so the document cannot say which plan it serves. Where the plan itself published the base URL on its own site, that is the plan putting its name behind the address and the entry is attributed to the plan, with the verification record saying plainly that the conformance document does not. Where only a vendor or a URL path segment connects the two, the endpoint is excluded instead.
Membership sources
- DHCS: Medi-Cal Plan with Medi-Medi Plans in 2026 (statewide plan-by-county table) (retrieved 2026-08-07)
- DHCS: Medi-Cal Managed Care Health Plan Directory (retrieved 2026-08-07)
- Covered California: rates and plans for 2026 (eleven issuers) (retrieved 2026-08-07)
Listed endpoints
| Plan | Programs | Endpoint | Category | Grade |
|---|---|---|---|---|
| Inland Empire Health Plan | Medi-Cal managed care, Covered California | Inland Empire Health Plan Patient Access API | Payer Patient Access APIs | B |
| Inland Empire Health Plan | Medi-Cal managed care, Covered California | Inland Empire Health Plan Provider Directory API | Payer Provider Directory APIs | D |
| Kaiser Permanente | Medi-Cal managed care, Covered California | Kaiser Permanente Health Plan Patient Access API | Payer Patient Access APIs | A |
| L.A. Care Health Plan | Medi-Cal managed care, Covered California | L.A. Care Health Plan Provider Directory API | Payer Provider Directory APIs | A |
| Sharp Health Plan | Covered California | Sharp Health Plan Patient Access API | Payer Patient Access APIs | A |
| Sharp Health Plan | Covered California | Sharp Health Plan Provider Directory API | Payer Provider Directory APIs | D |
| Santa Clara Family Health Plan | Medi-Cal managed care | Santa Clara Family Health Plan Patient Access API | Payer Patient Access APIs | B |
| Santa Clara Family Health Plan | Medi-Cal managed care | Santa Clara Family Health Plan Provider Directory API | Payer Provider Directory APIs | D |
| Health Plan of San Mateo | Medi-Cal managed care | Health Plan of San Mateo Patient Access API | Payer Patient Access APIs | A |
| Central California Alliance for Health | Medi-Cal managed care | Central California Alliance for Health Provider Directory API | Payer Provider Directory APIs | A |
| Community Health Group Partnership Plan | Medi-Cal managed care | Community Health Group Provider Directory API | Payer Provider Directory APIs | A |
Grades are comparable within a category only: a Patient Access API and a Provider Directory API answer to different expectations and are never ranked against each other.
Members reviewed and not listed
Each exclusion records how far the review went, on what date, and where to check it. A review that found nothing is not proof that nothing exists: if one of these plans publishes a base URL we missed, please tell us.
| Plan | Programs | Why it is not listed |
|---|---|---|
| Anthem Blue Cross (Elevance Health) | Medi-Cal managed care, Covered California | the documented brand endpoint answers, but its CapabilityStatement cannot be attributed to the California brand: three consecutive requests to the same Anthem Blue Cross URL returned documents identical except for id and date, whose implementation.url named AnthemBlueCrossBlueShield, then AnthemBlueCross, then Wellpoint (the plan's own documentation was reviewed, 2026-08-07; source) |
| Blue Shield of California (including Promise Health Plan) | Medi-Cal managed care, Covered California | developer portal requires an account; the Patient Access product page lists resource paths but no base URL, and production access needs an attestation form (the plan's own documentation was reviewed, 2026-08-07; source) |
| Health Net Community Solutions | Medi-Cal managed care, Covered California | the plan routes developers to the Centene partner portal, which publishes no base URL to an unregistered visitor; the Centene production host documented by an affiliated Centene plan does not resolve in public DNS (the plan's own documentation was reviewed, 2026-08-07; source) |
| CalViva Health | Medi-Cal managed care | the plan routes developers to the Centene partner portal, which publishes no base URL to an unregistered visitor (the plan's own documentation was reviewed, 2026-08-07; source) |
| Molina Healthcare of California | Medi-Cal managed care, Covered California | developer portal published; Provider Directory calls can be tried against mock data without an account, but Patient Access endpoints require sign-in and no production base URL is printed (the plan's own documentation was reviewed, 2026-08-07; source) |
| Community Health Plan of Imperial Valley | Medi-Cal managed care | the plan publishes production base URLs in its own hosted API documentation and the host does not resolve in public DNS (the plan's own documentation was reviewed, 2026-08-07; source) |
| Partnership HealthPlan of California | Medi-Cal managed care | the plan publishes production base URLs for both APIs on its own developer page and neither answers: the Provider Directory returns 404 and the Patient Access endpoint returns 401 (the plan's own documentation was reviewed, 2026-08-07; source) |
| Kern Family Health Care | Medi-Cal managed care | the plan publishes base URLs for both APIs in its own hosted documentation and both return HTTP 404 (the plan's own documentation was reviewed, 2026-08-07; source) |
| Health Plan of San Joaquin | Medi-Cal managed care | only a sandbox base URL is published and it returns 401; in the plan's own documentation the production endpoint is an unfilled placeholder (the plan's own documentation was reviewed, 2026-08-07; source) |
| Mountain Valley Health Plan | Medi-Cal managed care | covered by the same documentation as Health Plan of San Joaquin, with the same outcome: sandbox only, and it returns 401 (the plan's own documentation was reviewed, 2026-08-07; source) |
| Contra Costa Health Plan | Medi-Cal managed care | the live developer page could not be retrieved; an archived copy documents a Patient Access host that does not resolve and a Provider Directory that answers but is attributable only to its vendor (the plan's own documentation was reviewed, 2026-08-07; source) |
| Alameda Alliance for Health | Medi-Cal managed care | developer portal published on a shared vendor platform; no base URL is rendered to an unregistered visitor (the plan's own documentation was reviewed, 2026-08-07; source) |
| CalOptima Health | Medi-Cal managed care | developer portal published on a shared vendor platform; no base URL is rendered to an unregistered visitor (the plan's own documentation was reviewed, 2026-08-07; source) |
| San Francisco Health Plan | Medi-Cal managed care | developer portal published on a shared vendor platform; no base URL is rendered to an unregistered visitor (the plan's own documentation was reviewed, 2026-08-07; source) |
| CenCal Health | Medi-Cal managed care | developer portal published on a shared vendor platform; no base URL is rendered to an unregistered visitor (the plan's own documentation was reviewed, 2026-08-07; source) |
| Gold Coast Health Plan | Medi-Cal managed care | developer portal published on a shared vendor platform; no base URL is rendered to an unregistered visitor (the plan's own documentation was reviewed, 2026-08-07; source) |
| Chinese Community Health Plan (Balance by CCHP) | Covered California | the interoperability page carries a heading for the endpoint list and the list itself is missing from the page (the plan's own documentation was reviewed, 2026-08-07; source) |
| Valley Health Plan | Covered California | no interoperability or developer documentation could be located (public search only; the plan's documentation was not located, 2026-08-07; source) |
| Western Health Advantage | Covered California | no interoperability or developer documentation could be located (public search only; the plan's documentation was not located, 2026-08-07; source) |
Observational snapshots of public discovery surfaces. Not audits, not compliance determinations, and not statements about care quality. Publishing a base URL to unregistered visitors is not required by any rule this project reads, and a plan that does not is not violating anything; it is only not independently checkable from outside.