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, HCA is required to complete and published certain audits.
Are appendices included?
No. Appendices are not included due to privacy laws.
Encounter Data Validation (EDV)
2026
- Community Health Plan of Washington
- Coordinated Care
- Molina Healthcare of Washington
- UnitedHealthcare Community Plan of Washington
- Wellpoint Washington
2024
- Community Health Plan of Washington
- Coordinated Care
- Molina Healthcare of Washington
- UnitedHealthcare Community Plan of Washington
- Wellpoint Washington (previously Amerigroup)
2021
- Community Health Plan of Washington
- Coordinated Care
- Molina Healthcare of Washington
- UnitedHealthcare Community Plan of Washington
- Wellpoint Washington (previously Amerigroup)
Financial
2026
- Community Health Plan of Washington
- Coordinated Care (IFC/IMC)
- Molina Healthcare of Washington
- UnitedHealthcare Community Plan of Washington
- Wellpoint Washington
2024
- Community Health Plan of Washington
- Coordinated Care (IFC/IMC)
- Molina Healthcare of Washington
- UnitedHealthcare Community Plan of Washington
- Wellpoint Washington (previously Amerigroup)
Network
2024
- Community Health Plan of Washington
- Coordinated Care
- Molina Healthcare of Washington
- UnitedHealthcare Community Plan of Washington
- Wellpoint Washington (previously Amerigroup)
Claims
2024
- 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)
-
For calendar years 2020 through 2024: 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).