Requesting The Auditor To Conduct A Management And Financial Audit Of The State's Medicaid Health Care Insurance Contractors On A Biennial Basis.
The proposed audits aim to assess financial integrity, performance, and compliance with various regulations for each Medicaid contractor. The resolution highlights concerns regarding past incidents of overpayments related to provider ineligibility and lack of proper authorization, emphasizing the necessity of rigorous audits to identify these issues effectively. The resolution outlines a framework for cooperation between the contractors and the auditor, thereby ensuring transparency and accountability in managed care operations.
Senate Resolution 29 requests the Hawaii state auditor to conduct biennial management and financial audits of the state's Medicaid health care insurance contractors. This resolution stems from the need for improved oversight of managed care organizations that contract with the Department of Human Services, ensuring that public funds are utilized effectively and that quality health care is delivered to beneficiaries. Given the significant impact of Medicaid on the state budget, structured oversight is deemed essential for the program's sustainability.
One of the notable points raised in discussions around SR29 is the historical context of the auditor's authority. While the auditor has had the power to conduct such audits since 1975, this authority has not been exercised until now, raising questions about previous oversight practices and the effectiveness of existing monitoring systems. The failure to conduct audits has resulted in repeated issues, including fraud and the need for corrective actions. Supporters of the resolution argue that the proposed audits will lead to enhanced health care outcomes for Medicaid beneficiaries, whereas opponents may express concerns regarding the potential burden on managed care organizations and the implications for the delivery of services.