HOUSE OF REPRESENTATIVES

H.C.R. NO.

134

TWENTY-FIFTH LEGISLATURE, 2010

 

STATE OF HAWAII

 

 

 

 

 

HOUSE CONCURRENT

RESOLUTION

 

 

REQUESTING A comprehensive MANAGEMENT AND FINANCIAL AUDIT of for-profit entities contracted as managed care providers for the department of human services's quest expanded access program.

 

 

 


     WHEREAS, in 1965, the United States Congress established Medicaid as a jointly funded state and federal program that provides medical assistance to low-income individuals who qualify under Title XIX of the Social Security Act; and

 

     WHEREAS, within a general statutory framework, each state creates and administers its own Medicaid program; and

 

     WHEREAS, in the State of Hawaii, the Med-QUEST Division of the Department of Human Services (DHS) administers the Medicaid Program; and

 

     WHEREAS, the Med-QUEST Division oversees a number of programs that provide coverage for certain medical, mental health, and dental services for qualified children and adults, including Medicaid Fee-For-Service, Hawaii QUEST, and QUEST Expanded Access; and

 

     WHEREAS, the various Med-QUEST programs are financed through the State and the Federal Centers for Medicare and Medicaid Services; and

 

     WHEREAS, DHS developed the QUEST Expanded Access Program to administer Medicaid benefits for Hawaii's 37,000 aged, blind, and disabled residents; and

 

     WHEREAS, DHS administers the Medicaid health care coverage program, including QUEST Expanded Access, through several contracts with managed care providers; and

     WHEREAS, two of these contracts were awarded to for-profit insurance companies; and

 

     WHEREAS, several states have found a number of serious law violations and instances of Medicaid fraud while administering similar Medicaid programs through for-profit insurance companies; and

 

     WHEREAS, Medicaid fraud squanders limited funds, threatens safety, and cheats taxpayers, thereby inhibiting government efforts to obtain necessary health care and services for Hawaii's vulnerable populations; and

 

     WHEREAS, it is particularly imperative to ensure proper management and fiscal responsibility with respect to State-run programs during periods of economic difficulty; now, therefore,

 

     BE IT RESOLVED by the House of Representatives of the Twenty-fifth Legislature of the State of Hawaii, Regular Session of 2010, the Senate concurring, that the Auditor is requested to perform a comprehensive management and financial audit of the for-profit entities contracted by DHS to administer the QUEST Expanded Access Program; and

 

     BE IT FURTHER RESOLVED that the audit should cover the life of each contract; and

 

     BE IT FURTHER RESOLVED that DHS is requested to cooperate with and assist the Auditor in the performance of this audit; and

 

     BE IT FURTHER RESOLVED that the Auditor report all findings and recommendations to the Legislature no later than twenty days prior to the convening of the Regular Session of 2011; and

 

     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Governor, Auditor, Director of Human Services, and Administrator of the Med-QUEST Division.

 

 

 

 

OFFERED BY:

_____________________________

 


Report Title: 

QUEST Expanded Access Contracts; Audit