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).

Annual metrics

Review the 2017-2018 annual program integrity metrics for additional information.