1 health insurance risk-sharing plan legislative audit bureau may 2004
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HIRSP Background Established to provide major medical insurance
for those who cannot obtain private coverage for health reasons
Also provides coverage to those who have lost employer-sponsored health insurance
18,273 policyholders enrolled as of 5/31/04
DHFS oversees the Plan
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Audits of Controls Independent internal control audits of
HIRSP’s pharmacy benefit management company would provide additional assurance that necessary safeguards and controls are in place and working
DHFS will require independent reviews in its future contract for HIRSP’s plan administrator
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Technical Statutory Issue Funding formula overcredits policyholders
for deductible and drug subsidies because of a technical statutory provision
A portion of related costs are not being allocated to any funding party
DHFS and the Board plan to pursue statutory changes to address the issue in the 2005-07 legislative session