OCA lays out PIP framework; board asks for clear timelines, transparency and penalty parameters OCA presented an enforcement roadmap that emphasizes progressive steps — technical assistance, then performance improvement plans (PIPs) before typical administrative penalties — and described statutory constraints, confidentiality rules, monitoring obligations, and potential penalty authority to be defined with board input.

California's Office of Health Care Affordability is rolling out a new framework for Performance Improvement Plans that could reshape how entities manage spending and accountability in healthcare.

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