Audits and reporting

Oversight results

As required by 42 CFR 438.602, HCA is required to complete and published certain audits. **NOTE: Appendices are not included in the links below due to privacy laws.

Encounter Data Validation (EDV)

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

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 year 2020: 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).

• For calendar year 2021: 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).

• For calendar year 2022: 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).