“The Department of Human Services (DHS) is committed to eliminating all fraud, waste and abuse. The Department appreciates the assistance of the Legislature and the State Auditor’s Office to help identify areas to reduce medical assistance program costs and to improve program integrity,” said DHS Director Patricia McManaman. “The Auditor’s Report, however, relied on outdated information and did not recognize the Department’s substantial progress under the Abercrombie Administration to enhance program integrity and eliminate abuses,” said McManaman.
Since the 2011 federal report was issued, the DHS has implemented new systems, processes, screening and enrollment requirements, contractual requirements for health plans, and launched a new eligibility system, KOLEA — all with the goal of reducing fraud and waste.
The DHS is seeking funds from the 2014 Legislature for an additional investigator, fraud auditor and program integrity manager. Funding also is being sought for an asset verification IT system, which will interface with KOLEA. The verification system will improve program integrity for all individuals still subject to asset verification.
The Auditor’s Report expressly recognizes that Hawaii’s Medicaid program fares well when compared to peer states in the rest of the nation. It also notes that DHS has managed to control its costs on a per-enrollee basis even in the face of growing Medicaid enrollment. In 2010, Hawaii’s per-enrollee costs were 19 percent lower than the average among peer states.
Hawaii’s efforts to control costs did not come at the expense of quality. In 2013, the Commonwealth Fund ranked Hawaii as the state with the best health care system for low income individuals. “The Med-QUEST staff is dedicated to providing timely access to quality care for beneficiaries, while assuring proper oversight of taxpayer dollars. Ultimately, it is my responsibility to assure program integrity throughout the Department,” said McManaman.
An estimated 301,000 individuals are enrolled in the Hawaii Medicaid program, which is administered through the Department of Human Services.
For more information about the Department of Human Services, Med-QUEST Division visit http://humanservices.hawaii.gov/mqd.