Bill > A05825

This bill directs the state comptroller to conduct comprehensive audits of the Department of Health and other state agencies every three years to ensure proper oversight of Medicaid managed care organizations (MCOs). The audit will specifically evaluate MCOs' compliance with federal and state requirements, focusing on two key areas: maintaining an adequate network of healthcare providers and adhering to mental health and substance use disorder parity requirements. Following the audit, the comptroller must publish a detailed report that includes an assessment of each MCO's compliance, explanations for compliance determinations, and an examination of annual fraud and abuse complaints. The report must be distributed to various state officials, including the governor, attorney general, legislative leaders, and committee chairs responsible for health, mental health, and substance use disorders. The first report is to be published by July 1st of the year following the bill's enactment, with subsequent reports issued every three years. By mandating these regular audits, the bill aims to improve oversight and ensure that Medicaid managed care organizations are meeting critical healthcare standards and providing appropriate coverage to their enrollees.

Government Affairs

https://www.nysenate.gov/legislation/bills/2025/A5825