Statement From Auditor McGuiness On Judge’s Ruling

DOVER, Delaware – Today, Delaware State Auditor Kathleen McGuiness released the following statement in response to the Memorandum Opinion and Order from the court confirming the Auditor’s Office’s power to conduct performance audits:

Judge Karsnitz released his decision in our court case with the Delaware Department of Health and Social Services (DHSS) regarding our requests to audit Medicaid spending. My office fought for nearly two years for access to information needed to conduct a performance audit set within the professional standards and guidelines of the U.S. Government Accountability Office. This audit sought to determine if DHSS’ Division of Medicaid and Medical Assistance (DMMA) complies with federal and state requirements, implements effective internal controls, and incorporates data integrity throughout the program.

Medicaid spending accounts for nearly 1/5 of the state’s annual budget, and Delawareans deserve to know if Medicaid is complying with state and federal requirements when spending these critical funds.

The Auditor’s Office regularly receives confidential data as part of our duties under Delaware Code, and the prior administration conducted a nearly identical performance audit of Medicaid eligibility in 2014. However, despite a history of conducting this work, my staff and I received significant pushback and delays that undermine the independent audit process in our state.

This performance audit was hindered by the Department of Justice (DOJ) and their insistence this audit was not within the Auditor’s scope of authority. My staff was forced to learn to draft a subpoena because the assigned attorney from the Department of Justice declined to provide my office legal representation on this matter. The DOJ initially refused to grant my office outside legal counsel forcing us to represent the office pro se.

I would like to thank Judge Karsnitz for his objective ruling confirming the scope of authority of the Auditor’s Office. I commend Governor John Carney for his judgement in granting the office independent outside legal counsel. I applaud the efforts of Luke Mette of Armstrong Teasdale LLP and his team for their outstanding legal expertise and presentation of the facts.

There’s been a lot of confusion about what this office does or should be doing, but this decision makes it clear; taxpayers deserve to know if they’re getting a fair deal from their state government, and Delawareans should know they have fighters on their side in the State Auditor’s Office working on their behalf for accountability no matter the resistance.

Read the Court’s Memorandum Opinion and Order here.


Contact: Tori Parker, Deputy Auditor

DHSS Announces Organizations Selected to Operate Medicaid Managed Care Program

NEW CASTLE (July 12, 2022) – The Department of Health and Social Services (DHSS) announced today that it has selected three companies to operate its Medicaid Managed Care Program.

DHSS’ Division of Medicaid and Medical Assistance (DMMA) will continue its MCO partnership with Highmark Health Options Blue Cross Blue Shield, which began in 2015, and with AmeriHealth Caritas, which began in 2018. In addition, DHSS announced its intent to contract with Centene’s Delaware First Health.

“We are pleased to reach agreement with Highmark, AmeriHealth and Centene to provide these vital services to the Medicaid members we serve,” DHSS Secretary Molly Magarik said. “These companies not only will offer more choice to our Medicaid members, but they also understand Delaware’s commitment to value-based care, and to the critical services that our Medicaid members need and deserve. We appreciate the commitment of Highmark, AmeriHealth and Centene to providing a connection to care and support that will help our Medicaid members achieve their optimal health.”

In 2017, Gov. John Carney signed House Joint Resolution 7, which gave DHSS the authority to develop health care spending and quality benchmarks. The spending benchmark – a spending target – is linked to the growth rate of Delaware’s economy and includes all health care spending, including through Medicaid, Medicare and commercial insurers. The quality benchmarks are established periodically to offer strategic goals to improve the health of Delawareans and the care they receive.

Delaware’s Medicaid program serves about 300,000 members. Division of Medicaid and Medical Assistance Director Steve Groff said members will receive information during the next several weeks about their options in choosing a new plan for 2023. Open enrollment will begin Oct. 1.

DHSS Anuncia Organizaciones Seleccionadas para Operar el Programa de Atención Administrada de Medicaid

NEW CASTLE (Julio 12, 2022) – El Departamento de Salud y Servicios Sociales (DHSS) anunció hoy que ha seleccionado tres compañias para operar su Programa de Atención Administrada de Medicaid.

La División de Medicaid y Asistencia Médica (DMMA) del DHSS continuará su asociación de MCO con Highmark Health Options Blue Cross Blue Shield, que empezó en el 2015, y con AmeriHealth Caritas, que empezó en el 2018. Además, DHSS anunció su intención de contratar con Delaware First Health de Centene.

“Nos complace llegar a un acuerdo con Highmark, AmeriHealth y Centene para brindar estos servicios vitales a los miembros de Medicaid a los que servimos,” dijo la Secretaria del DHSS, Molly Magarik. “Estas compañías no solo ofrecerán más opciones a nuestros miembros de Medicaid, pero también entienden el compromiso de Delaware con la atención de salud basada en valor y con los servicios críticos que nuestros miembros de Medicaid necesitan y merecen. Agradecemos el compromiso de Highmark, AmeriHealth y Centene de brindar una conexión con la atención y apoyo que ayudarán a nuestros miembros de Medicaid a lograr una salud óptima.”

En 2017, el Gobernador John Carney firmó la Resolución Conjunta 7 de la Cámara de Representantes, que otorgó al DHSS la autoridad para desarrollar indicadores de calidad y gasto en atención médica. El punto de referencia de gastos – un objetivo de gastos – está vinculado a la tasa de crecimiento de la economía de Delaware e incluye todos los gastos de atención médica, incluso a través de Medicaid, Medicare y aseguradoras comerciales. Los puntos de referencia de calidad se establecen periódicamente para ofrecer objetivos estratégicos para mejorar la salud de los habitantes de Delaware y la atención que reciben.

El programa Medicaid de Delaware atiende cerca de 300.000 miembros. El Director de la División de Medicaid y Asistencia Médica Steve Groff, dijo que los miembros recibirán información durante las próximas semanas sobre sus opciones al elegir un nuevo plan para el 2023. La inscripción abierta comenzará el 1 de Octubre.