Medicaid legislation seeks greater accountability—and taxpayer savings

Responding to new reports that Illinois paid millions for medical services for persons already recorded as dead, legislation has been introduced intending to weed out Medicaid waste, fraud, and abuse; make the system work for the people who truly need the benefits; and save Illinois tax dollars.

Senate Bill 815 states that the Department of Healthcare and Family Services (DHFS) must contract with a third-party vendor to examine Illinois’ Medicaid rolls. That vendor would make sure Medicaid recipients on the list are eligible to receive benefits. This process would include income verification and determining whether the person is alive.

The Illinois Auditor General reported in early February that DHFS paid $3.7 million for medical services to about 1,100 people who were already recorded as dead. Though the state says almost 100 percent of the payments will be recovered, Medicaid reform proponents point to the multi-million dollar snafu as reason for more concentrated redetermination efforts. Similarly, the AP reported in early 2014 that a state audit found an estimated $12 million had been paid for medical services for deceased people.

In 2013, a state-hired private contractor, Maximus, identified more than 220,000 people it said should be dropped from the Medicaid rolls. Illinois then removed more than 114,000 from the system. But, before Maximus could finish combing through the millions of more names in the system, the Quinn Administration stripped the company of its ability to make case review recommendations.


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