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A Report on Health and Human Services Commission Contracts

October 2015

Report Number 16-006

Overall Conclusion

Senate Bill 20 (84th Legislature) required that, in devising its audit plan, the State Auditor's Office must consider performing audits of Health and Human Services Commission (Commission) contracts that exceed $100 million in annual value, including contracts between the Commission and managed care organizations. Pursuant to that requirement, the State Auditor's Office compiled a list of Commission contracts with an aggregate value exceeding $100 million, as well as all contracts for managed care services. Additionally, the State Auditor's Office identified completed or ongoing audit work conducted from September 2011 through June 2015 related to those contracts.

Based on unaudited information from the Commission's Health and Human Services Contract Administration and Tracking System, the State Auditor's Office identified 57 contracts that met the criteria discussed above. Those contracts included:

- Six contracts related to various aspects of operating the Medicaid, Children's Health Insurance, Medical Transportation, and Trauma Facilities programs.

- Six contracts related to information technology and telecommunications services.

- Four contracts related to pharmacy providers for the Vendor Drug Program.

- Forty-one contracts that provide Medicaid managed care services.

According to the Commission, as of June 2015, expenditures for those 57 contracts totaled nearly $46.1 billion ($12.7 billion of those expenditures were made in fiscal year 2014). It is important to note that some Commission management and staff have expressed concerns about the accuracy of the expenditure information in the Commission's Health and Human Services Contract Administration and Tracking System. However, for the purposes of this project, the Health and Human Services Contract Administration and Tracking system was the most complete repository of Commission contract data, including expenditures associated with those contracts.

The State Auditor's Office will include the information identified in this report in its risk assessment process for selecting contracts to audit during fiscal year 2016.

A list of the 57 contracts discussed above is presented in the report. The report also includes descriptions of those contracts or the program services provided through those contracts, as well as information on completed or ongoing related audit work.

Contact the SAO about this report.

Download the Acrobat version of this report. (.pdf)