REQUESTING THE AUDITOR TO CONDUCT A MANAGEMENT AND FINANCIAL AUDIT OF THE STATE'S MEDICAID HEALTH CARE INSURANCE CONTRACTORS ON A BIENNIAL BASIS.

This House Resolution (HR 104) requests the State Auditor to conduct biennial management and financial audits of Hawaii's Medicaid health care insurance contractors (managed care organizations). It directly affects these contractors, requiring them to cooperate with the Auditor by providing necessary records. The resolution mandates audits to assess financial integrity, compliance with laws/regulations, and contractor performance, with the first audit due within six months of July 1, 2025. The Auditor must submit findings to the Governor, Legislature, and Human Services Director by January 2027, and every two years thereafter. This follows past issues including Medicaid overpayments and a 2023 federal review identifying gaps in fraud prevention.