Health Net
One of California’s largest Medi-Cal managed care plans — and, in 2025, the subject of a court-ordered injunction over inaccurate provider directories. Here’s the history, who owns it, how it works with the State, and what the court order actually says.
Sources: Centene investor relations (acquisition completed 3/24/2016); Centene / California Health & Wellness corporate disclosures; company histories. Founding year is given as c. 1977 in company histories (some sources differ); we note the uncertainty rather than assert a single date.
History
From a California HMO to a Centene subsidiary
Health Net began as a California health maintenance organization (HMO) in the late 1970s and grew through a series of mergers that were typical of the consolidating managed-care industry. Over two decades it combined with other carriers, went public, and was renamed — before ultimately being acquired by a national Medicaid-focused company.
Today, “Health Net” is not a single company but a family of related entities under Centene Corporation, the largest Medicaid managed-care company in the United States. That corporate lineage matters: it shapes who is accountable, who is paid, and who answers to California regulators.
- c. 1977 — Founded as a California HMO (Health Net of California).
- 1994 — Combines with QualMed to form Health Systems International, Inc.
- 1997 — Merges with Foundation Health Corporation to form Foundation Health Systems — one of the largest publicly traded HMOs in the U.S.
- 2000 — Renamed Health Net, Inc. (NYSE-listed).
- Mar 24, 2016 — Centene Corporation completes its acquisition of Health Net, Inc. (DMHC approved March 22, 2016).
Sources: company histories (FundingUniverse, Encyclopedia.com); Centene Investor Relations, “Centene Completes Acquisition of Health Net” (Mar 24, 2016); DMHC/CDI merger-approval reporting. The 2016 deal was valued at roughly $6 billion (reported figures range from about $6.0B to $6.8B depending on the measurement date).
Corporate structure
Who owns Health Net
The four “Health Net” entities named as defendants in the 2025 injunction sit beneath Centene. Understanding the chart below explains why a single court order names several different corporations.
Why four names appear in one lawsuit
The People v. Health Net injunction names Health Net, LLC; Health Net of California, Inc.; Health Net Community Solutions, Inc.; and California Health and Wellness Plan — collectively “Health Net.” They are bound together (along with successors, assignees, and contractors acting on their behalf) by the same order.
Source: People v. Health Net, Final Judgment & Permanent Injunction, Parties & Definitions (§§ 2–8).
Relationship with the State of California
How Health Net works with the State to manage Medi-Cal
Two regulators, two roles
Health Net’s California plans are licensed and regulated by the under the Knox-Keene Act, which sets rules on finances, grievances, and access to care.
Separately, the Department of Health Care Services (DHCS) administers Medi-Cal and contracts with Health Net to serve Medi-Cal members. For Knox-Keene-licensed Medi-Cal plans, DMHC and DHCS share oversight.
Where Health Net serves Medi-Cal
Per recent DHCS and Health Net materials, Health Net’s Medi-Cal managed care footprint has included Amador, Calaveras, Inyo, Los Angeles, Mono, Sacramento, San Joaquin, Stanislaus, Tulare, and Tuolumne counties, plus subcontracting roles supporting CalViva Health (Fresno, Kings, Madera) and the Imperial County plan.
Service areas change with DHCS contract cycles (a major overhaul took effect January 2024) — verify the current list against the live DHCS Medi-Cal Managed Care directory.
Public money, public accountability
Medi-Cal is funded by state and federal taxpayers. When a plan is paid public dollars to build a network and then maintains a directory full of unreachable providers, the harm is twofold: members can’t get care, and the public pays for access that doesn’t materialize. That is the throughline connecting SB 530 (which keeps access standards in force) and the 2025 injunction (which targets directory accuracy).
Dental: the DentaQuest relationship
Who actually runs Health Net’s Medi-Cal dental network
For Medi-Cal dental coverage, Health Net’s dental benefits are administered through California Dental Network, Inc., doing business as DentaQuest — meaning Health Net dental members use the DentaQuest provider network, and dentists submit authorizations and claims through DentaQuest.
DentaQuest is a national dental-benefits company and the largest Medicaid/CHIP dental administrator in the U.S. It has been a subsidiary of Sun Life Financial since June 2022 (a ~$2.475 billion acquisition).
The state doesn’t just hope a dental network is adequate — it measures it. California’s Dental Managed Care (DMC) network-adequacy methodology sets the standards a network like this has to meet: how close a dentist must be, how many per member, and in what languages. See the methodology, decoded → And in DHCS’s 2021 certification to the federal government, the State counts prosthodontists as a specialty — and requires out-of-network access when a plan has none.
What this means in practice
When a Health Net Medi-Cal dental member needs a referral or a specialist, it is DentaQuest — not Health Net directly — that manages the dental network, the provider directory members rely on, and the authorizations and claims that flow through it. DentaQuest both runs its own Medi-Cal dental plan in Los Angeles and Sacramento counties and administers dental benefits for Health Net in those same counties.
Sources: Health Net Medi-Cal member dental materials (“administered by DentaQuest”); California regulatory filings naming “California Dental Network, Inc. d.b.a. DentaQuest”; Sun Life completion of DentaQuest acquisition (June 1, 2022); Centene and DentaQuest 2024 DHCS dental-award announcements.
The public record
Recent California regulatory actions
A factual record of recent state actions involving Health Net entities. Allegations are not findings of liability; where a matter settled without an admission, we say so.
| Date | Action | Amount | Status |
|---|---|---|---|
| Oct 13, 2025 | CA Attorney General + San Diego City Attorney settlement over allegedly inaccurate provider directories (this page’s injunction) | ~$40M total ($12M payment + ~$28.5M six-year investment) | Settled — no admission |
| Feb 4, 2026 | DMHC fines for failing to timely acknowledge/resolve provider payment disputes (Health Net Community Solutions $850K; Health Net of California $450K) | $1.3M | DMHC enforcement |
| Mar 27, 2023 | DMHC fine over improperly paid provider claims (Health Net of California); ~34,433 claims remediated (~$1.2M to providers) | $225K fine | DMHC enforcement |
Sources: oag.ca.gov press release (Oct 13, 2025); DMHC press releases (Feb 4, 2026; Mar 27, 2023); contemporaneous reporting (Becker’s Payer Issues, Insurance Journal, Times of San Diego).
The 2025 injunction, made readable
People of the State of California v. Health Net
In 2021, the San Diego City Attorney sued three insurers — Health Net, Kaiser, and Molina — alleging their provider directories were riddled with “ghost” listings. The California Attorney General later joined the Health Net matter. In October 2025 it ended in a court-ordered injunction. Below is a faithful, plain-language presentation of that order. Click any highlighted term to hear its official definition read aloud.
Read the official Stipulation & Final Judgment (PDF · oag.ca.gov)
Important: this was a settlement, not a finding of guilt
Health Net denied wrongdoing. The judgment was entered “without trial or adjudication of any fact or law,” and does not constitute “an admission by Defendants regarding any issue of law or fact alleged in the Complaint.” Health Net agreed to the directory improvements and payments to resolve the matter. We describe the People’s claims as allegations, and the injunction’s requirements as what Health Net agreed to do.
Source: People v. Health Net, Stipulation ¶ 2 & Final Judgment (Introduction).
What the People alleged Allegation
That Health Net’s mental-health and medical were inaccurate in ways that misled consumers — listing providers who were no longer contracted, had wrong contact information, or weren’t accepting new patients — making the network look more complete than it was and leaving members unable to get care. Reporting cited an overall directory error rate exceeding ~18%, and higher still for psychiatrists.
Source: California Attorney General press release (Oct 13, 2025); 2021 complaint coverage. Error-rate figures are from reporting, not the judgment text.
Key definitions in the order
The injunction defines the words it uses. Click to hear each one read aloud, verbatim:
What Health Net agreed to do Ordered
The heart of the injunction is a set of concrete directory-accuracy obligations. Most rely on an — software that runs at least monthly. In plain terms, Health Net must:
Remove duplicate listings
Use an Automated Process to find and remove all .
Fix phone numbers
Switch the online directory to 11-digit provider phone numbers, and auto-correct 10-digit numbers that begin with “1” or “0.”
No phantom addresses
Prohibit providers from listing any address where they don’t actually practice; cross-check directory addresses against the service location in Box 32 of providers’ CMS-1500 claim forms.
Flag telehealth-only providers
identify, in both the listing and search results, when a provider specializes in or exclusively provides telehealth.
Purge inactive providers
Use an Automated Process to identify and remove inactive providers — or remove those with no claims in 12 months and reinstate only on the provider’s attestation that their listing is accurate.
Show “not accepting new patients”
For psychotherapists and primary care physicians with no new-patient activity in six months (and no statement that they’re accepting patients), the listing must say so.
Show a “last updated” date
Display, in each listing, the date the entry was last updated.
Remove the departed
Use Automated Processes to remove providers who are no longer contracted, and to remove unlicensed or deceased providers.
Screen against official databases
Cross-check providers against state and federal sources — licensing boards, the National Practitioner Data Bank, OIG exclusion lists, OFAC, the Social Security Death Master File, the CMS Preclusion List, and more — and remove those who shouldn’t be listed.
Correct bad name/address/phone data
Use an Automated Process to correct or remove inaccurate information — or, alternatively, cross-reference claims contact info at least annually, audit key fields quarterly, and audit all phone numbers annually.
Tell members their out-of-network rights
Display a that members have a right to coverage if they inadvertently get out-of-network care by relying on an inaccurate listing.
Make the directory usable
Hire a consultant to improve the directory (especially for behavioral health) and add an easy one-click “report an inaccuracy” button leading to a form.
Act on complaints
Promptly address every directory-accuracy complaint, and treat each report or flag as triggering all obligations under Health & Safety Code § 1367.27(o).
Keep records
Maintain copies of the Provider Directories for five years.
Run a 24/7 help line
Operate a with multilingual support, returning overnight messages the next business day.
Notify members & employers
Tell members (Medi-Cal and commercial) and employer customers that Health Net enhanced its directory in conjunction with the Attorney General and San Diego City Attorney.
Obey the underlying laws
Comply with Business & Professions Code §§ 17200 & 17500 and Health & Safety Code §§ 1367.27 & 1374.72.
Accuracy must be proven, not assumed
For several of the automated processes, Health Net must validate the data to be at least 90% accurate by a statistically valid sample within six months of implementation.
Source: Final Judgment § III.10.
The compliance timetable
The order phases the obligations in over the months following entry of judgment:
| Due (from entry of judgment) | What must be in place |
|---|---|
| 1 month | Out-of-network coverage-rights notice |
| 3 months | Remove duplicates; fix “1/0” phone numbers; complaint handling; 5-year recordkeeping; member/employer notice |
| 4 months | Usability consultant + reporting button; 24/7 phone line |
| 6 months | “Last updated” dates; remove no-longer-contracted providers |
| 8 months | 11-digit numbers; phantom-address controls; CMS-1500 checks; inactive/unlicensed/deceased purges; database screening; data-correction process |
| 9 months | Telehealth-only flagging |
Source: Final Judgment § III.11. If Health Net can’t meet a deadline, it must notify the People of the delay and the reason.
The money
Ordered payment
$4M to the Attorney General and $4M to the San Diego City Attorney within 30 days; plus $2M to each by September 1, 2026.
Final Judgment § IV.13.
Six-year investment
Health Net represented that the directory improvements will require an investment of about $28.5 million over six years. Together with the $12M payment, this is the basis for the widely reported “~$40 million” settlement figure.
Stipulation ¶ 9; AG press release (Oct 13, 2025).
The order has teeth
The court retains jurisdiction to enforce the judgment; the Attorney General intends ongoing compliance monitoring; and the People retain all enforcement powers, including under Business & Professions Code § 17207, for any violation. A violation of the judgment may result in additional relief.
Source: Final Judgment §§ VI.15–19; Stipulation ¶ 7.
In one sentence
Without admitting fault, Health Net agreed — under a court order the State can enforce — to clean up and keep cleaning its provider directories, prove the cleanup actually works, run a 24/7 help line, tell members their out-of-network rights, and pay $12 million plus invest about $28.5 million over six years.
With gratitude to the people who enforced the law
We thank the California Attorney General’s Office and the San Diego City Attorney’s Office for their hard work holding health plans accountable and helping some of California’s most vulnerable residents obtain access to medically necessary care. Enforcement like this is what turns rights on paper into real care — and it is the standard every Medi-Cal member deserves.
In the news
Recent coverage
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Oct 13, 2025 · Office of the Attorney Generaloag.ca.gov — official press release · Stipulation & Final Judgment (PDF)
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Oct 13, 2025 · San Diego City Attorneysandiego.gov — official announcement (PDF)
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Oct 13, 2025 · Times of San Diegotimesofsandiego.com
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Oct 17, 2025 · Insurance Journalinsurancejournal.com
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Jun 25, 2021 · KPBSkpbs.org — the original “ghost network” filing
All links verified live as of June 2026 and open in a new tab. The February 2026 DMHC fines ($1.3M) are summarized in the regulatory-record table above, sourced to DMHC press releases.
📰 See the full Press Gallery — Medi-Cal ghost networks, fines & settlements →