California Department of Managed Health Care (DMHC) Director Shelley Rouillard has issued an order approving Blue Shield of California’s (Blue Shield) acquisition of Care1st Health Plan (Care 1st). “This order brings Blue Shield into the Medi-Cal program and requires the plan to improve quality and access for Medi-Cal beneficiaries. Prior to approval, my team performed an exhaustive review of all aspects of the proposed transaction, performed complex legal analyses, conferred with external experts and considered all public comments,” said Director Rouillard.