Bill > SB1180

This bill requires the State Auditor to conduct comprehensive management and financial audits of Medicaid health care insurance contractors (managed care organizations contracted with the Department of Human Services) at least once every two years, with the first audit to be completed within six months of July 1, 2025, and the first audit report submitted no later than twenty days before the 2027 Regular Session. The audits will assess the financial integrity, performance, and legal compliance of these contractors, with the power to review all relevant documents and records. Contractors are mandated to cooperate fully with the audit process, providing all requested information. The State Auditor will submit detailed findings and recommendations to the Governor, Legislature, and Director of Human Services, and may conduct additional audits as deemed necessary. The bill is motivated by previous findings of inefficiencies, potential overpayments, and insufficient oversight in Hawaii's Medicaid program, including a 2023 Centers for Medicare and Medicaid Services review that highlighted gaps in fraud prevention and inter-agency coordination. To support these audits, the bill includes an appropriation of funds from general state revenues for fiscal years 2025-2026 and 2026-2027, with the act taking effect on July 1, 2025.

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https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=SB&billnumber=1180&year=2026