Audits and reporting
The Health Care Authority (HCA) oversees, examines, and monitors its contracted providers and participating managed care entities to ensure compliance with statutory and contractual requirements.
Oversight results
As required by 42 CFR 438.602(e), the HCA completed an encounter data validation review of each managed care organization in July 2021. The final audit notice and report for each managed care organization is published below as required by 42 CFR 438.602(g)(4).
- Community Health Plan of Washington
- Coordinated Care
- Molina Healthcare of Washington
- UnitedHealthcare Community Plan of Washington
- Wellpoint Washington (previously Amerigroup)
Annual metrics
Medical Assistance Contractor Annual Metrics - RCW 74.09.195(2)(b):
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For calendar year 2020: Health Care Authority did not have a contractor conduct any audits on behalf of the medical assistance program required to be published under RCW 74.09.195(2)(b).
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For calendar year 2021: Health Care Authority did not have a contractor conduct any audits on behalf of the medical assistance program required to be published under RCW 74.09.195(2)(b).
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For calendar year 2022: Health Care Authority did not have a contractor conduct any audits on behalf of the medical assistance program required to be published under RCW 74.09.195(2)(b).