Bill > SR29

This resolution requests 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) on a biennial basis, with the first audit to be completed within six months of July 1, 2025. The resolution aims to ensure proper oversight of Medicaid funds, assess the financial integrity and performance of these contractors, and verify compliance with federal and state laws and regulations. The audits will involve reviewing documents related to financial and operational activities, with contractors required to cooperate and provide necessary records. The Auditor is requested to submit detailed findings and recommendations to the Governor, Legislature, and Director of Human Services at least 20 days before the Regular Session of 2027 and subsequent sessions following audit years. The resolution is motivated by previous findings of potential inefficiencies, overpayments, and gaps in program oversight, including a 2023 Centers for Medicare and Medicaid Services (CMS) review that identified multiple areas needing improvement in the state's Medicaid Managed Care Program. Additionally, the Auditor is granted the flexibility to conduct additional audits as deemed necessary based on risk assessments or upon request from state leadership.

Health and Social Services

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=SR&billnumber=29&year=2025