2018 Legislative Audits
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1. Summary of Report 2018-01: Performance Audit of the Division of Juvenile Justice Services
This audit reviewed the efficiency and effectiveness of the Division of Juvenile Justice Services (JJS or division). We found that despite decreasing juveniles served, the cost per juvenile has increased and this metric has not been tracked or reported by the division. JJS management functions needs to improve in that significant decisions have been made with regards to facilities and programming without conducting a cost-benefit analysis. We also found that JJS needs to improve transparency in the information that they present to policy makers. Finally, JJS should improve partnerships with private providers to help improve programming at a potential cost savings to the state.
2. Summary of Report 2018-02: An In-Depth Budget Review of the Utah Department of Health
This report found, through contracting with Milliman actuaries, that $74.6 million could have been saved from 2014-2016 if each plan had achieved the most efficient price, or on average $25 million per year. We believe that a more reasonable annual savings would be $4 to $8 million. DOH should regularly conduct efficiency analysis on the ACOs beyond the annual rate setting process. In addition, we found that in 2014, DOH randomly assigned over 23,000 members (18 percent of the ACO population) to plans, with approximately $50 million in total annual costs, DOH should consider assigning recipients who do not self-select a plan to a more efficient plan. DOH is not providing a strong enough control environment for the ACOs. We found the inconsistent coding and budget structure complicated our analysis. DOH should improve budget controls and reporting to foster a healthier review of its budget.
3. Summary of Report 2018-03: Performance Audit of the Inspector General of Medicaid Services
We found that the Office of the Inspector General of Medicaid Services (OIG) neglected independent oversight of Accountable Care Organizations (which were responsible for 38% of Medicaid expenditures in 2017). We also found that some OIG reporting and audit practices needed improvement. Finally, we recommended that the Legislature consider restructuring the OIG to increase its accountability and productivity.