The bill mandates the Office of the State Auditor (OSA) to produce an annual report detailing the activities of the Medicaid Audit Unit for the period from March 2, 2024, to February 28, 2025. This report will focus on the Unit's efforts to prevent and identify fraud, waste, and abuse within the MassHealth system, which serves around two million individuals in Massachusetts. The fiscal year 2025 budget for the Unit is set at $1,440,504, marking a 2.9% increase from the previous year. The report is expected to highlight potential cost savings of approximately $27,259,164 through various audits, including reviews of capitation payments and telehealth services, which uncovered unauthorized payments and issues related to deceased members.

Furthermore, the bill addresses the oversight of MassHealth's administration of the Medicaid program, particularly concerning Adult Foster Care (AFC) and Group Adult Foster Care (GAFC) services. Recent audits revealed significant deficiencies, such as inadequate oversight visits and improper documentation practices. In response, MassHealth has pledged to enhance monitoring controls, set annual audit goals for AFC and GAFC providers, and implement system edits to prevent incorrect telehealth coding. The bill underscores the importance of recovering overpayments and ensuring compliance with regulations, emphasizing the need for continuous improvement to maintain public confidence in the Medicaid program and ensure efficient use of taxpayer dollars.