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

October 2022


This report evaluates the Commission’s business processes for setting and implementing the Medicaid managed care rates, communicating the rates to oversight entities, and procuring its contracted actuary. This report also summarizes the rate-setting process and identifies significant drivers of costs in the rates. This is the second of three reports that the State Auditor’s Office will release to address Rider 5, page X-7, the General Appropriations Act (87th Legislature) requirements.