Bill > HB1274

This bill requires the State Auditor to conduct comprehensive management and financial audits of Medicaid health care insurance contractors (managed care organizations) at least every two years, with the first audit to be completed within six months of July 1, 2025, and the first audit report to be 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, including a thorough review of their books, records, and operational activities. Contractors must fully cooperate with the auditor by providing all requested documents and information. The auditor is mandated to submit detailed findings and recommendations to the governor, legislature, and director of human services, and may conduct additional audits as needed. The bill is motivated by previous program integrity reviews that identified issues with Medicaid oversight, including potential fraud, waste, and inefficiencies in managed care payments. To support these audits, the bill appropriates funds from the state's general revenues for fiscal years 2025-2026 and 2026-2027, with the specific funding amount to be determined. The legislation will take effect on July 1, 2025, and aims to improve transparency, ensure proper use of public funds, and enhance the quality of healthcare services for Medicaid beneficiaries.

Housing and Urban Affairs

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=HB&billnumber=1274&year=2026