HI HB2032

Requires the State Auditor to conduct a comprehensive study of managed care organizations that administer Hawaii's medicaid program (med-QUEST).

Study must include financial analysis of managed care organizations covering direct health care service payments, quality improvement costs, and administrative service costs with detailed breakdowns.

Study must assess network adequacy through "secret shopper" surveys to determine whether physicians listed as network providers actually accept medicaid managed care plan patients.

Study must assess the extent of upcoding by medicaid managed care plans to increase payments based on risk adjustment formulas that reward overdiagnosis.

Auditor must submit findings and recommendations to the legislature no later than twenty days before the 2023 regular legislative session; appropriates funds for fiscal year 2022-2023 for the study; takes effect July 1, 2022.