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 by 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 initial audit report due no later than twenty days before the 2027 Regular Session. The legislation mandates that these audits assess the financial integrity, performance, and compliance of contractors with federal and state laws, regulations, and contractual obligations, including a thorough review of documents related to their financial and operational activities. Contractors are required to cooperate fully with the auditor by providing all requested records and information. The State Auditor must submit a report of findings and recommendations to the Governor, Legislature, and Director of Human Services, and may conduct additional audits as needed based on risk assessments or upon request. The bill is motivated by previous findings of inefficiencies and potential financial mismanagement in Hawaii's Medicaid program, including overpayments, insufficient fraud prevention, and lack of coordination between state agencies. To support these new audit requirements, the bill includes an appropriation of funds from the state's general revenues for fiscal years 2025-2026 and 2026-2027, with the act set to take effect on July 1, 2025.

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https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=SB&billnumber=1180&year=2025