Utah
Office of the Legislative Auditor General
Published September 25, 2025

A Performance Audit of the Office of Inspector General of Medicaid Services: Policy Options for Improved Governance and Medicaid Oversight

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Overall Conclusion

The report concludes that Utah’s OIG has not adequately fulfilled its Medicaid oversight mandate and suffers from governance, reporting, and performance weaknesses, with risk-based planning and proactive oversight largely missing; it recommends policy options including structural changes to improve accountability and oversight.

Source Document

Audit Scope

2018 through 2024, with portions of 2025, covering the Office of Inspector General of Medicaid Services (OIG) functions, governance, planning, performance audits, and reporting.

Key Findings Summary

1

The OIG Leadership Has Failed to Adequately Prioritize High-Impact Audits and Therefore Has Been Delinquent in Fulfilling its Duties

2

The OIG Has Failed to Improve Its Office Governance and Impact

3

The OIG Has Operated Under a Limited Oversight Structure

View the Findings tab to see all 9 findings

AI-Assisted

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AI Scope Summary

Build on this audit by emphasizing future inquiries into formalizing risk-based annual planning, expanding performance audits of cost drivers and program outcomes, strengthening ongoing oversight of Accountable Care Organizations, improving governance and transparency, and evaluating alternative oversight structures used by other states.

AI-Generated Insight

This systemic performance audit identifies chronic governance, planning, and transparency gaps in Utah's OIG for Medicaid, revealing a reactive, under-resourced oversight model with uneven performance metrics. The findings suggest meaningful reforms—potentially restructuring oversight or increasing external accountability—to strengthen Medicaid governance and protect public funds.