Financial Monitoring

The Financial Monitoring section oversees the financial reporting of contracted Medicaid Health Maintenance Organizations (HMOs) and Provider Service Networks (PSNs).  As part of this function, the Financial Monitoring section monitors the financial performance and health of HMOs and PSNs through the analysis of various sets of quarterly and annual financial reports that are submitted on both Generally Accepted Accounting Principles (GAAP) and Statutory basis of accounting.  This also includes monitoring each plan for compliance with contractually financial requirements, including surplus and insolvency protection provisions.

The Financial Monitoring section also oversees the reporting of the Medical Loss Ratio (MLR) by contracted plans as well as the Achieved Savings Rebate, and manages contracts with certified public accounting firms contracted to audit financial reports for the purposes of calculating the Achieved Savings Rebate.