Hawaii Senate Bill SCR46

Hawaii 2025 Regular Session

• Introduced: 3/6/25
• Refer: 3/11/25

Caption

Requesting The Auditor To Conduct A Management And Financial Audit Of The State's Medicaid Health Care Insurance Contractors On A Biennial Basis.

Impact

SCR46 addresses significant issues related to Medicaid in Hawaii, where prior audits identified substantial overpayment and eligibility issues. The Auditor has had the legal authority to conduct such audits since 1975 but has not exercised this authority, making the proposed audits not only timely but necessary to enhance accountability. By requiring these audits, the resolution seeks to ensure compliance with both federal and state laws while promoting transparency and operational efficacy among contractors.

Summary

Senate Concurrent Resolution 46 (SCR46) is a legislative proposal requesting the State Auditor to perform management and financial audits of Medicaid health care insurance contractors on a biennial basis. The resolution emphasizes the importance of proper oversight of managed care organizations that contract with the Department of Human Services to provide Medicaid services. Given the substantial budgetary implications of Medicaid, the resolution aims to ensure the effective use of public funds and the delivery of quality care to beneficiaries.

Contention

The resolution highlights the gaps in the current oversight framework for Medicaid contractors, particularly regarding inadequate mechanisms to detect fraud and waste. A 2023 review by the Centers for Medicare & Medicaid Services indicated several areas needing improvement in Hawaii's Managed Care Program, which fortified the case for these mandated audits. Critics may contend that ongoing audits could create operational burdens for these contractors, yet supporters argue that they are essential for safeguarding public resources and ensuring beneficiaries receive the appropriate quality of care.