State of Rhode Island

Buyer is soliciting proposals for financial and programmatic audit services for HealthSource RI (HSRI) to ensure compliance with Centers for Medicare and Medicaid Services regulations. The audit must address compliance with federal requirements, evaluate processes to prevent improper eligibility determinations, and identify errors in eligibility determinations. Buyer requires audited financial statements along with compliance reports following GAGAS standards. The final reports must be submitted by May 15, 2026.

• 5/22/2025 - Vendor Q&A Start Date
• 6/6/2025 - Vendor Q&A End Date
• 6/20/2025 - Proposal Due Date
• 9/1/2025 - Contract Start Date

• Must be an eligible entity as defined by 45 C.F.R. § 155.110
• Must have experience with GAGAS financial and programmatic audits
• Must meet insurance requirements including professional liability coverage

• Perform independent external financial and programmatic audit following GAGAS standards
• Audit financial statements and program activities of HealthSource RI
• Evaluate compliance with 45 CFR 155.1200 requirements
• Review processes preventing improper eligibility determinations and enrollment transactions
• Identify errors resulting in incorrect eligibility determinations
• Issue audited financial statements with auditor's report
• Prepare compliance report documenting instances of non-compliance
• Evaluate SOC reports over Exchange's Service Organizations
• Issue management letter with recommendations
• Submit final reports by May 15, 2026