OLA — DHS Oversight of Managed Care Organizations (2018)

Source: Office of the Legislative Auditor, Minnesota · Document date: 2018-01-01 · Type: Audit Report

OLA evaluation of DHS oversight of Minnesota Medicaid managed care organizations (MCOs). Documents the structural gap between MCO contract value ($9B+) and DHS oversight capacity (4 contract management staff), and the MCO practice of treating fraud analytics as proprietary.

Significance: Foundational document for the DHS-MCO structural gap, MCO oversight gap, and mco-failures investigations. The 4-staff-for-$9B statistic originates from this report. Also documents the MCO data-sharing refusal pattern that OLA had been warning about since 2013.

Tags: OLA, audit, MCO, managed care, DHS oversight, legislative auditor