Audit Topic

Managed Care

Medicaid audit reports involving managed care oversight, capitation payments, MCO reporting, network adequacy, and encounter data.

US
2025

Illinois Medicaid Managed Care Capitation Payments for Incarcerated Enrollees

U.S. Department of Health and Human Services Office of Inspector General
Published 2025

The audit determined that Illinois made unallowable managed care capitation payments for incarcerated enrollees during the audit period, totaling at least $9.5 million with $8.3 million Federal share,...

US
2025

Medicaid Agencies Made Millions in Unallowable Capitation Payments to Managed Care Organizations on Behalf of Deceased Enrollees

Office of Inspector General, U.S. Department of Health and Human Services
Published 2025

We estimate that Medicaid agencies made $207,501,380 ($138,645,710 Federal share) in unallowable capitation payments to MCOs for deceased enrollees during the audit period (July 1, 2021 – June 30, 202...

NY
2025
Featured

Medicaid Program: Oversight of Managed Care Provider Networks

Office of the New York State Comptroller, Division of State Government Accountability
Published 2025

DOH did not maintain sufficient oversight of Medicaid managed care provider networks during 2023, with data reliability and process control issues affecting the accuracy of deficiency reporting and SO...

NY
2025

Medicaid Program: Improper Premium Payments Made on Behalf of Managed Care Members Residing Outside the State

Office of the New York State Comptroller, Division of State Government Accountability
Published 2025

None

US
2025

Washington Medicaid Managed Care Medical Loss Ratio Audit

Centers for Medicare & Medicaid Services
Published 2025

CMS identified eight findings requiring correction, but none resulted in an MLR recalculation below the 85% remittance threshold; the audit identified operational improvements and oversight enhancemen...

US
2025
Featured

Ohio Medicaid Managed Care Medical Loss Ratio Audit

Centers for Medicare & Medicaid Services, Center for Program Integrity
Published 2025

While no remittances were required based on the findings, the audit identified multiple areas for improvement in Ohio’s oversight and reporting processes to ensure compliance with federal requirements...

US
2025

Medicaid Managed Care Improper Payment Estimate

U.S. Government Accountability Office
Published 2025

The GAO report highlights that while CMS's current improper payment estimates for Medicaid managed care are near zero, they do not capture all program integrity risks. CMS has taken steps to improve o...

LA
2025
Featured

Managed Care Incentive Payment Program

Louisiana Legislative Auditor
Published 2025

LDH’s design and lack of oversight of the MCIP program led to the majority of MCIP funds being paid for activities that do not have a direct, measurable result for how they improve access to healthcar...

US
2025

Colorado Made Capitation Payments to Managed Care Organizations After Enrollees’ Deaths

Office of Inspector General, U.S. Department of Health and Human Services
Published 2025

The audit found that Colorado made unallowable capitation payments to Medicaid managed care organizations for deceased enrollees, resulting in significant financial losses and reporting inaccuracies. ...

US
2024

CMS Did Not Ensure That Selected States Complied With Medicaid Managed Care Mental Health and Substance Use Disorder Parity Requirements

Office of Inspector General, Department of Health and Human Services
Published 2024

CMS did not ensure that selected States complied with Medicaid managed care MH/SUD parity requirements; noncompliance was widespread across eight States, including missing parity provisions in contrac...

CA
2024
Featured

The Comprehensive Perinatal Services Program

California State Auditor
Published 2024

The State has provided limited oversight of the Comprehensive Perinatal Services Program and has not meaningfully improved the program. Data limitations and insufficient oversight hinder the ability t...

MD
2023

Maryland Department of Health Medical Care Programs Administration Managed Care Program Audit Report

Office of Legislative Audits, Maryland General Assembly
Published 2023

MDH’s corrective actions addressing the identified audit issues are considered sufficient to address all audit issues.

US
2023

Multiple States Made Medicaid Capitation Payments to Managed Care Organizations After Enrollees’ Deaths

Office of Inspector General, Department of Health and Human Services
Published 2023

The report concludes that improper Medicaid capitation payments to MCOs on behalf of deceased enrollees remain a persistent issue across states, with prior unallowable payments totaling about $249 mil...

FL
2023

Medicaid Managed Care Contract Monitoring Follow-Up and Oversight of Health Plan Complaint and Grievance Handling Operational Audit

Florida Auditor General
Published 2023

The audit identified deficiencies in internal controls related to ECGA reporting, data summaries, and follow-up actions, indicating a need for strengthened oversight and documentation.

US
2023

New York Did Not Ensure That A Managed Care Organization Complied With Requirements For Denying Prior Authorization Requests

Office of Inspector General
Published 2023

The audit concluded that the New York State Department of Health’s oversight was ineffective in ensuring that CPHL complied with requirements for denying prior authorization requests, resulting in del...

TX
2023

An Actuarial Analysis Of The Health And Human Services Commission’s Fiscal Year 2024 Medicaid Managed Care Rates Actuarial Soundness

Texas State Auditor's Office
Published 2023

The FY 2024 Texas Medicaid managed care capitation rates are actuarially sound overall, with no material program-wide under- or over-funding detected. Milliman identifies several recommendations to st...

US
2023

Oregon Medicaid Managed Care Medical Loss Ratio Audit

Centers for Medicare & Medicaid Services
Published 2023

The audit identified areas for improvement in Oregon's Medicaid managed care MLR reporting and oversight processes. While no immediate remittance was required, implementing the recommendations will en...

TX
2022

An Audit Report on the Health and Human Services Commission's Medicaid Managed Care Rate-Setting Process

Texas State Auditor's Office
Published 2022

Milliman concluded that FY2023 capitation rates were actuarially sound, with no program-wide pattern of under- or over-funding, though improvements were recommended in several rate-setting and governa...

US
2022

Nearly All States Made Capitation Payments for Beneficiaries Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Two States

Office of Inspector General, Department of Health and Human Services
Published 2022

CMS did not concur with the recommendations. The OIG maintains that the recommendations are valid and will continue to work with States to identify opportunities to reduce the number and amount of con...

TX
2022

An Audit Report on Cook Children’s Health Plan, a Managed Care Organization

Texas State Auditor’s Office
Published 2022

Cook Children’s Health Plan accurately reported STAR Kids medical and pharmacy expenses in FY 2020 and complied with eligibility requirements for medical and pharmacy claims. However, improvements are...

TX
2021
Featured

An Audit Report on Blue Cross Blue Shield of Texas, a Managed Care Organization

State Auditor’s Office
Published 2021

The audit found that while the Health Plan accurately reported medical, administrative, and quality improvement expenses, its pharmacy expense reporting was flawed due to unallowable practices by the ...

MO
2020

Medicaid Managed Care Program

Missouri State Auditor
Published 2020

The audit found material weaknesses in MEDES controls that allowed improper and potentially preventable capitation payments to be issued, particularly for bypassed and out-of-state and incarcerated pa...

TX
2019

An Audit Report on Medicaid Managed Care Contract Processes at the Health and Human Services Commission

State Auditor’s Office
Published 2019

The audit found that the Health and Human Services Commission has made significant progress in establishing processes and controls related to Medicaid managed care contract management, in compliance w...

TX
2019

Medicaid Managed Care Contract Processes at the Health and Human Services Commission

Texas State Auditor’s Office
Published 2019

The Commission has made significant progress in establishing processes and controls for Medicaid managed care contract management, aligning with Senate Bill 894 requirements. However, further efforts ...