Given the extent of auditing and public disclosure required of Minnesota health plan finances and operations, I found it very disappointing that veteran legislator Sen. John Marty, in a recent MinnPost commentary, would make the irresponsible claim that $3 billion in payments to health plans are made with no auditing and minimal reporting.
Minnesota statute requires extensive auditing of health plan finances and has internal controls in place to ensure the accuracy and validity of financial transactions. These audit responsibilities are shared jointly by the Minnesota Department of Health, the Department of Human Services, and the Department of Commerce.
Plus, for legislators and taxpayers who want more information on health plan spending for medical care and administrative services, the following documents are available online at the Minnesota Dept. of Health’s web site: our 2009 IRS Form 990 and Executive Compensation; 2009 Statement of Revenue, Expenses, and Net Income; and the most recent financial examination by the Minnesota Department of Commerce. Also, we are required to file an annual audited financial statement with the Department of Commerce that is available for free downloading on the web site of the National Association of Insurance Commissioners.
Other audits examine operations outside of finances. There are state audits of a health plan’s compliance with contracting standards and federal requirements for service authorization, quality improvement, disease management, consumer grievances and appeals, ensuring providers are properly credentialed to meet care standards, and others.
We also report regularly to federal health agencies. Since we provide health services to seniors on Medicare, we are subject to auditing by the federal Centers for Medicare & Medicaid Services related to our financial records, medical and administrative costs, cash flow and investment income, claims, medical records, care quality, and much more.
As a Minnesota health plan with more than 25 years of experience in government programs, we take very seriously our responsibility to be prudent and accountable stewards for the public funding we receive to administer the state’s health care programs.
We are proud to provide health care and wellness services to more than 200,000 seniors and low-income members from a wealth of cultures while keeping our administrative costs to only 6.6 percent of revenues. And we strongly support the state’s role in a robust system of oversight and public transparency for health plan finances. Sen. Marty need not wait for a new administration to open health plan books; he need only point his mouse and click.
Nancy J. Feldman is president and CEO of UCare.