As of February 2018, the Commission had completed a risk assessment to determine which MCOs it would select for upcoming performance audits, as required by S.B. 894.
Using its risk assessment, the Commission developed an audit plan that prioritized auditing the highest risk MCOs and included conducting performance audits of
MCOs’ pharmacy benefit managers.
However, as of November 2018, the Commission had not started the performance audits in that most recent audit plan.
The Commission developed policies and procedures specifying when a corrective action plan should be issued based on the results of an AUP engagement;
however, as of November 2018, the Commission had not issued any corrective action plans based on its AUP engagements.
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