The Legislative Audit Bureau makes 7 recommendations to the Office of the Commissioner of Insurance.

We recommend the Office of the Commissioner of Insurance:  

1. 1. 1. follow its policies by randomly selecting the individuals whose claims it will include in its annual Phase I and Phase II audits of claims submitted by health insurers participating in the Wisconsin Healthcare Stability Plan; (p. 9)
      2. consistently follow its policies by selecting 60 individuals whose claims it will include in its Phase I audits; (p. 9)
      3. modify its policies to require it to select at least two individuals from each health insurer in its Phase I audits; (p. 9)
      4. attempt to verify as part of its audits at least two claims associated with each of the 60 individuals whose claims are included in a given year’s audit; and (p. 10)
      5. report to the Joint Legislative Audit Committee by June 30, 2022, on its efforts to implement these recommendations. (p. 10)

We recommend the Office of the Commissioner of Insurance report to the Joint Legislative Audit Committee by June 30, 2022, on:

1. 1. 6. the extent to which the Wisconsin Healthcare Stability Plan has met the goals specified in statutes and Wisconsin’s waiver over the first three years; and (p. 15)
      7. the status of its efforts to extend the Wisconsin Healthcare Stability Plan for another five years. (p. 15)