Bill > HCR108

This concurrent resolution requests the State Auditor to conduct biennial management and financial audits of Hawaii's Medicaid health care insurance contractors (defined as managed care organizations contracted with the Department of Human Services), with the first audit to be completed within six months of July 1, 2025. The resolution stems from multiple findings highlighting the need for improved oversight, including a 2023 Centers for Medicare and Medicaid Services (CMS) program integrity review that identified significant issues with Medicaid program management, such as inadequate fraud prevention, ineffective payment mechanisms, and poor inter-agency coordination. The requested audits are intended to assess financial integrity, performance, and compliance with federal and state laws, with contractors required to cooperate by providing necessary documentation. The Auditor is requested to submit comprehensive reports to the Governor, Legislature, and Director of Human Services no later than twenty days before the 2027 Regular Session and subsequent sessions following audit years, with the option to conduct additional audits as needed. The ultimate goals are to promote transparency, ensure appropriate fund usage, verify quality of care for Medicaid beneficiaries, and improve the overall effectiveness of Medicaid health care insurance contractors.

Housing and Urban Affairs

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=HCR&billnumber=108&year=2025