Summary — HCR 108 (2025): Requesting biennial audits of the State’s Medicaid health care insurance contractors
Status: Concurrent resolution — introduced Mar 12, 2025; adopted by both chambers May 26, 2025; enrolled and transmitted to Governor May 28, 2025; signed by the Governor June 22, 2025.
Primary sponsors: Dorazio, Raymond, Guillen, Longoria, Amato, Shimizu, Grandinetti, Poepoe, Perruso.
Companion measures: SCR 41 (Senate), HR 104 (House).
Purpose
- HCR 108 formally requests the State Auditor to conduct management and financial audits of the State’s Medicaid health care insurance contractors on a biennial (every two years) basis.
- The resolution’s intent is to increase fiscal and operational oversight of entities that administer Medicaid benefits under state contracts (commonly managed care organizations / Medicaid contractors), to verify proper use of Medicaid funds, contract compliance, and the effectiveness of contractor management practices.
Key provisions
- Directs/requesting language: the resolution asks the State Auditor to perform both management and financial audits of each Medicaid health care insurance contractor every two years.
- Audit scope (as implied by resolution language): audits would cover financial records and management practices related to administering Medicaid contracts — e.g., payments and claims processing, accounting and financial solvency, internal controls, contract compliance, and use of subcontractors. (The resolution establishes the request; specific audit scope and methodology would be set by the State Auditor.)
- No statutory changes to Medicaid contracts are contained in the resolution; it is a formal request for recurring audits rather than a change in law or contract terms.
Who is affected
- Primary: Medicaid health care insurance contractors / managed care organizations that contract with the State to deliver Medicaid services.
- Secondary: State Medicaid program administration (oversight functions), the Office of the State Auditor (responsibility to plan and carry out audits), Medicaid recipients (indirectly, through potential improvements in service delivery and accountability), and state finances (potential recoveries, cost savings, or audit costs).
Procedural / timeline notes
- The resolution requires audits on a biennial schedule; the resolution does not specify the start date for the first audit, nor does it appropriate funding for audit work. Implementation (timing, scope, and cost) depends on the State Auditor’s planning and available budgetary resources.
- Because this is a concurrent resolution, it is a formal legislative request/statement rather than a statute changing legal requirements; its effectiveness depends on the State Auditor’s acceptance and any necessary appropriation to conduct the audits.
Potential impacts
- Increased oversight and transparency of Medicaid contractor finances and management.
- Possible identification of improper payments, contract noncompliance, or opportunities for efficiency—leading to recoveries or policy changes.
- Administrative and resource impacts for the State Auditor (workload and cost) and for contractors (preparation and cooperation for audits).
