Hawaii House Bill HR104

Hawaii 2025 Regular Session

• Introduced: 3/7/25
• Refer: 3/14/25

Caption

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

Summary

H.R. 104 is a House Resolution requesting the Hawaii State Auditor to conduct a management and financial audit of the State’s Medicaid health care insurance contractors, meaning the managed care organizations that contract with the Department of Human Services to deliver Medicaid managed care plans. The resolution asks that these audits occur every two years, with the first audit to begin within six months of July 1, 2025. The resolution directs the audits to examine each contractor’s financial integrity, performance, compliance with federal and state laws, regulations, and contract terms, and to review relevant books, records, and other evidence related to operations and finances. It also asks contractors to cooperate fully with the Auditor and requires the Auditor to report findings and recommendations to the Governor, Legislature, and Director of Human Services on a recurring schedule. The Auditor may also conduct additional audits based on risk assessments or requests from state leaders.

Impact

Because this is a resolution rather than a bill amending statutes, H.R. 104 does not directly change Hawaii law or create new regulatory requirements. Instead, it formally requests the State Auditor to use existing authority to perform recurring oversight of Medicaid managed care contractors and to share findings with state officials. If carried out, the resolution would increase scrutiny of Medicaid managed care operations, potentially affecting contractor practices, documentation, compliance procedures, and coordination with the Department of Human Services.

Sentiment

The overall sentiment reflected in the resolution is strongly supportive of increased oversight and accountability. The measure is framed as a response to concerns about Medicaid fraud, waste, abuse, overpayments, and weaknesses identified in federal and state reviews, and it presents auditing as necessary to protect public funds and improve care for beneficiaries. No committee testimony or vote record is provided, so there is no recorded opposition or formal legislative debate in the materials supplied.

Contention

The main point of contention implied by the resolution is whether the State has adequately overseen Medicaid managed care contractors and whether existing coordination among agencies is sufficient. The resolution cites prior findings of overpayments, inadequate fraud-prevention mechanisms, and weak interagency coordination, suggesting concern that current oversight has been ineffective. Any resistance would likely come from contractors or agencies concerned about administrative burden, audit costs, or the implications of repeated findings, but no direct opposition is shown in the provided record.