Bill > HR104

This resolution requests the State Auditor to conduct 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 managed care organizations by requiring comprehensive audits that assess financial integrity, performance, and compliance with federal and state laws and contractual obligations. The audits will involve reviewing documents and records related to the contractors' financial and operational activities, with the expectation that contractors will fully cooperate by providing requested information. The Auditor is requested to submit detailed findings and recommendations to the Governor, Legislature, and Director of Human Services at least twenty days before the Regular Session of 2027 and subsequent sessions following an audit year. The resolution is motivated by previous findings of Medicaid program inefficiencies, potential overpayments, and gaps in oversight, as identified by federal reviews and state investigations, with the ultimate goal of promoting transparency, ensuring appropriate use of public funds, and improving healthcare outcomes for Medicaid beneficiaries.

Housing and Urban Affairs

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=HR&billnumber=104&year=2025