The bill mandates the Office of the State Auditor (OSA) to provide an annual report on the activities of the Medicaid Audit Unit for the period from March 2, 2024, to February 28, 2025. This report will detail the Unit's efforts in preventing and identifying fraud, waste, and abuse within the MassHealth system, which serves around two million individuals in Massachusetts. The OSA is required to submit its findings to the House and Senate Committees on Ways and Means by the end of February 2025, including audit results, MassHealth's post-audit actions to recover payments, and recommendations for improving recoupment efforts. The fiscal year 2025 budget for the Unit is set at $1,440,504, reflecting a 2.9% increase from the previous year.

The bill also addresses oversight issues within MassHealth's administration of the Medicaid program, particularly concerning Adult Foster Care (AFC) and Group Adult Foster Care (GAFC) services. Recent audits have uncovered problems such as insufficient oversight by registered nurses, inadequate documentation for caregiver services, and incorrect coding of telehealth services. In response, MassHealth has pledged to implement various recommendations, including enhancing monitoring controls and provider education. Furthermore, the bill introduces new legal language focused on MassHealth's recoupment of payments, highlighting the agency's commitment to recovering overpayments and ensuring compliance with regulations, thereby enhancing the integrity and efficiency of the Medicaid program.