The Legislative Audit Council released a follow-up review of the agency Tuesday.

Members of the General Assembly requested the 2000 review to address financial concerns about the fund. Medical malpractice claims and awards have been increasing over the past five years, the report found.

The fund had not maintained reserves to pay future claims and was not subject to the oversight of the state Insurance Department like other insurance entities in the state. The fund had set no limit on the amount of an award that it would cover, the report said.

The 2000 audit also found that the fund had management problems, including inadequate written policies and procedures. The fund also violated the Freedom of Information Act in the way it conducted meetings and the Administrative Procedures Act by not setting regulations to establish board policy for fund membership and administration.

Since the 2000 review, administrative and legislative changes have been made, according to the audit council.

Lawmakers enacted changes to increase the fund's accountability and to reduce its liability. The fund's operations are now examined by the Insurance Department every three years. The fund must file an annual financial report.

The new audit also found the fund has developed and implemented a plan of operations, a manual of rules and rates, and a claims manual.

Lawmakers have not acted on other recommendations of the audit, such as placing a cap on the fund's liability or enacting statutory requirements for reporting claims.

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