Review Of Title XXI Hawaii State Children's Health Insurance Program

EXECUTIVE SUMMARY:

We found that the State overstated its State Children's Health Insurance Program (SCHIP) expenditures, incorrectly claimed managed care expenditures, and incorrectly reported and claimed SCHIP fee-for-service expenditures.  Also, some beneficiaries did not meet program eligibility requirements.  We recommend that the State credit the SCHIP program for $1,407,199 of overstated expenditures, implement claims processing controls to identify SCHIP expenditures, work with the Centers for Medicare and Medicaid Services to adjust Medicaid quarterly expenditures reports for prior periods, and educate its staff regarding eligibility requirements for the SCHIP program.